Individual
MRS. MANDY GALLAWAY LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
721 RESERVOIR AVE, CRANSTON, RI 02910-4430
(401) 946-4250
(401) 275-5645
Mailing address
721 RESERVOIR AVE, CRANSTON, RI 02910-4430
(401) 946-4250
(401) 275-5645
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT01516
RI
Other
Enumeration date
08/09/2010
Last updated
09/03/2015
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