Individual
MRS. THERESA LAVELLE EARTHLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1217 WILLOW GLEN RIVER RD, ALEXANDRIA, LA 71302-5454
(318) 487-4400
(318) 487-0525
Mailing address
1217 WILLOW GLEN RIVER RD, ALEXANDRIA, LA 71302-5454
(318) 487-4400
(318) 487-0525
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2476
LA
Other
Enumeration date
12/29/2010
Last updated
12/29/2010
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