Individual
LACY EADS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1628 19TH ST, LUBBOCK, TX 79401-4832
(806) 441-6019
Mailing address
3510 76TH ST, LUBBOCK, TX 79423-1208
(806) 441-6019
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
114055
TX
Other
Enumeration date
08/02/2024
Last updated
08/02/2024
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