Individual
MARCELLA E LACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2530 9TH AVE W, BRADENTON, FL 34205-4829
(941) 932-3284
Mailing address
2530 9TH AVE W, BRADENTON, FL 34205-4829
(941) 932-3284
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/22/2022
Last updated
05/22/2022
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