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General NPI Number Information
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NPI Number | 1659306512
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Entity Type | Individual
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Provider Name | MYRA LALL M.A.
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Gender | Female
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 01/27/2024
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Provider Practice Location Address
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Address Line | 1 WELBY RD
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City | NEW BEDFORD
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State | MA
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Zip | 02745-1137
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Country | US
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Telephone | 508-558-9700
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Fax | 508-676-0935
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Provider Business Mailing Address
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Address Line | PO BOX 186
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City | SOMERSET
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State | MA
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Zip | 02726-0186
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Country | US
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Telephone | 508-558-9700
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Fax | 508-676-0935
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 383
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License Number State | MA
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