Individual
MR. KEVIN LALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
1 W CENTRE ST, MAHANOY CITY, PA 17948-2670
(570) 773-3470
Mailing address
1 W CENTRE ST, MAHANOY CITY, PA 17948-2670
(570) 773-3470
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW018621
PA
Other
Enumeration date
04/21/2015
Last updated
06/23/2015
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