Individual
LACEY THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
3817 E STILES LN, GILBERT, AZ 85295-0143
(413) 386-5133
Mailing address
3817 E STILES LN, GILBERT, AZ 85295-0143
(413) 386-5133
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6494
AZ
Other
Enumeration date
11/07/2011
Last updated
07/01/2024
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