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Individual
MRS. MOLLIE D LACKEY
Active
Individual
MRS. MOLLIE D LACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-S
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
S-0028697
OH
1041C0700X
Clinical Social Worker
Primary
1100136-SUPV
OH
Other
Enumeration date
03/12/2008
Last updated
07/21/2022
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