Individual
LACIE MARIE TEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
304 HIGHWAY 61 N, WAPELLO, IA 52653-1243
(319) 523-8436
(319) 523-7079
Mailing address
304 HIGHWAY 61 N, WAPELLO, IA 52653-1243
(319) 523-8436
(319) 523-7079
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/02/2022
Last updated
06/11/2025
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