Individual
MS. MARILYN ANN LACELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
2190 NW COYOTE CREEK LN, ISSAQUAH, WA 98027-5604
(425) 392-8973
Mailing address
2190 NW COYOTE CREEK LN, ISSAQUAH, WA 98027-5604
(425) 392-8973
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LW00006687
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LW00006687
LICENSED SOCIAL WORKER
WA
Enumeration date
03/31/2008
Last updated
03/31/2008
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