Organization
LACY CLAYTON WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LACY RAE CLAYTON DNP PMHNP-BC (OWNER)
(267) 944-6220
Entity
Organization
Contact information
Practice address
102 WAVERLY RD, WYNCOTE, PA 19095-1322
(267) 944-6220
Mailing address
102 WAVERLY RD, WYNCOTE, PA 19095-1322
(267) 944-6220
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/08/2023
Last updated
09/08/2023
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