Individual
KANZIS MALON LACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
31 E MAIN AVE, TAYLORSVILLE, NC 28681-2540
(704) 872-0123
Mailing address
163 SADDLEWOOD LN, STATESVILLE, NC 28625-5522
(704) 450-1006
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/25/2022
Last updated
03/25/2022
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