Individual
LACY JANNINE CRUZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
43335 K BEACH RD STE 36, SOLDOTNA, AK 99669-8280
(907) 262-6331
Mailing address
1550 EAST 74TH AVE., ANCHORAGE, AK 99507
(907) 929-5826
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
05/24/2021
Last updated
02/06/2023
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