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Individual

SUSAN LALLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
707 WH SMITH BLVD, GREENVILLE, NC 27834-3752
(252) 758-6080
Mailing address
2075 NC 121, GREENVILLE, NC 27834-7188
(252) 702-3457

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
211939
NC

Other

Enumeration date
06/20/2019
Last updated
06/20/2019
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