Sean Lally
Prevention Professional in Wooster, OH. Individual provider (NPI-1).
NPI number1972158012
StatusActive
Last updated in NPPESAug 6, 2019
Details
- NPI
- 1972158012
- Entity type
- Individual (NPI-1)
- Name
- Sean Lally
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 6, 2019
- Last updated
- Aug 6, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 405300000X | Prevention Professional | 1619070 | OH | Yes |
Practice location
104 Spink StWooster, OH 44691-3652
Phone 330-264-8498 · Fax 330-264-3777
Mailing address
104 Spink StWooster, OH 44691-3652
Phone 330-264-8498 · Fax 330-264-3777
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