Individual
JAY LACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCDC
Contact information
Practice address
1500 N POST OAK RD STE 150, HOUSTON, TX 77055-5413
(713) 589-4730
(713) 589-4730
Mailing address
2611 MARLIN DR, TEXAS CITY, TX 77591-9167
19039488366
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
8203
TX
Other
Enumeration date
08/01/2017
Last updated
08/01/2017
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