Individual
MICHELLE LALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
151 W LUZERNE ST STE 110, PHILADELPHIA, PA 19140-2732
(215) 400-3900
Mailing address
151 W LUZERNE ST STE 110, PHILADELPHIA, PA 19140-2732
(215) 400-3900
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
137388
PA
Other
Enumeration date
06/14/2022
Last updated
06/14/2022
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