Provider Demographics
NPI:1851610596
Name:LALLI, CAMILLE CAPPO (BA)
Entity type:Individual
Prefix:MRS
First Name:CAMILLE
Middle Name:CAPPO
Last Name:LALLI
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 LOUISE DR
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-7032
Mailing Address - Country:US
Mailing Address - Phone:918-424-6442
Mailing Address - Fax:
Practice Address - Street 1:1710 LOUISE DR
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-7032
Practice Address - Country:US
Practice Address - Phone:918-424-6442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor