Individual
CHANNING RENEE LACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
222 W 6TH ST, CORONA, CA 92882-3301
(888) 682-6282
Mailing address
13267 ROSWELL AVE, CHINO, CA 91710-4771
(909) 680-8019
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/04/2019
Last updated
08/27/2025
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