Provider Demographics
NPI:1205535564
Name:AGRELLA-SEVILLA, LAUREN JEAN (MED)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:JEAN
Last Name:AGRELLA-SEVILLA
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 LAKEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:BREVARD
Mailing Address - State:NC
Mailing Address - Zip Code:28712-4346
Mailing Address - Country:US
Mailing Address - Phone:828-551-6641
Mailing Address - Fax:
Practice Address - Street 1:106 LAKEVIEW AVE
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-4346
Practice Address - Country:US
Practice Address - Phone:828-551-6641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical