Individual
JASON A LAVALLEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC
Contact information
Practice address
29 N MAIN ST SUITE 300, MILLBURY, MA 01527-0000
(508) 475-5676
(000) 000-0000
Mailing address
29 N MAIN ST SUITE 300, MILLBURY, MA 01527
(508) 475-5676
(000) 000-0000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1792AD
MA
Other
Enumeration date
09/26/2024
Last updated
09/26/2024
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