Individual
ELIZABETH GRACE LACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
829 W ATLANTIC ST FL 3, SPRINGFIELD, MO 65803-1517
(417) 712-7438
Mailing address
829 W ATLANTIC ST FL 3, SPRINGFIELD, MO 65803-1517
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2022045280
MO
Other
Enumeration date
11/23/2022
Last updated
11/23/2022
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