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Individual
DR. WILBURN H LACKEY
Active
Individual
DR. WILBURN H LACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D. L.P.C. L.S.O.T
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
12383
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12383
L.P.C. LICENSE
TX
01
—
95294
LSOTP LICENSE
TX
Enumeration date
01/04/2007
Last updated
07/09/2007
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