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1083069223
JESSE DAVID LALLA
DEARBORN, MI
NPI
1083069223
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MI 6801095840)
Enumeration Date
2016-04-25
Last Update Date
2021-02-26
Business Address
JESSE DAVID LALLA LMSW
5500 AUTO CLUB DR
DEARBORN, MI 48126-2779
Phone number: 313-317-2000
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Mailing Address
JESSE DAVID LALLA LMSW
5111 AUTO CLUB DR
DEARBORN, MI 48126-2749
Phone number: 313-317-2000
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