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Individual
LACEY NICOLE KALB
Active
Individual
LACEY NICOLE KALB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSED
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
769241
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
769241
NEW YORK STATE CERTIFICATION
NY
Enumeration date
09/12/2013
Last updated
09/12/2013
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