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Individual
LACY L GUNN
Active
Individual
LACY L GUNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
002260-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002260-1
DEPARTMENT OF EDUCATION OFFICE OF THE PROFESSIONS
NY
01
—
120502180
BOARD OF CERTIFICATION
—
Enumeration date
02/04/2020
Last updated
02/04/2020
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