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Individual

JULIANA LALLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1340 PARTRIDGE AVE, SAINT LOUIS, MO 63130-1943
(314) 854-5738
(314) 854-5750
Mailing address
1340 PARTRIDGE AVE, SAINT LOUIS, MO 63130-1943
(314) 854-5738
(314) 854-5750

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
001448
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
495961609
MO
Enumeration date
08/28/2008
Last updated
08/28/2008
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