Individual
ANTONIO D LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1324 CRESTMARK BLVD, LITHIA SPRINGS, GA 30122-4428
(770) 728-3468
(404) 591-6748
Mailing address
1324 CRESTMARK BLVD, LITHIA SPRINGS, GA 30122-4428
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
03/25/2013
Last updated
03/25/2013
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