Individual
LACEY LOSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
44899 CENTRE CT STE 102, CLINTON TOWNSHIP, MI 48038-5510
(586) 792-1654
Mailing address
44899 CENTRE CT STE 102, CLINTON TOWNSHIP, MI 48038-5510
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/22/2020
Last updated
09/07/2022
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