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Individual

MRS. ABIGAIL SUSAN LACEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
3613 WILLIAMS DR STE 302, GEORGETOWN, TX 78628-1369
(512) 713-9886
Mailing address
4801 MALLARD LN, KILLEEN, TX 76542-3787
(850) 603-0726

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
91552
TX
390200000X
Student in an Organized Health Care Education/Training Program
IMH20788
FL

Other

Enumeration date
03/16/2021
Last updated
07/27/2023
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