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1861052979
SUSAN LALLY
GREENVILLE, NC
NPI
1861052979
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: NC 211939)
Enumeration Date
2019-06-20
Last Update Date
2019-06-20
Business Address
SUSAN LALLY
707 WH SMITH BLVD
GREENVILLE, NC 27834-3752
Phone number: 252-758-6080
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Mailing Address
SUSAN LALLY
2075 NC 121
GREENVILLE, NC 27834-7188
Phone number: 252-702-3457
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