Individual
MICHAEL ALBIN LACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
2141 ALTOONA AVE, EAU CLAIRE, WI 54701
(715) 552-7350
(715) 878-9075
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
33333
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39365600
—
WI
Enumeration date
03/20/2007
Last updated
09/16/2016
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