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Individual

LACEY NOELLE CUMMINGS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
551 KOKOPELLI BLVD UNIT E, FRUITA, CO 81521-6305
(970) 858-2526
(970) 858-8244
Mailing address
PO BOX 130, FRUITA, CO 81521-0130
(970) 858-2186
(970) 858-2208

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
3473
AL
225X00000X
Occupational Therapist
Primary
OT.0004530
CO
225X00000X
Occupational Therapist
OT15103
FL

Other

Enumeration date
06/08/2016
Last updated
09/11/2023
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