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Individual

CARLYNN ALEXANDRA LACKEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
711 TARAVAL ST, SAN FRANCISCO, CA 94116-2516
(415) 861-0828
Mailing address
368 FELL ST, SAN FRANCISCO, CA 94102-5144
(415) 861-0828

Taxonomy

Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary

Other

Enumeration date
05/31/2019
Last updated
05/08/2025
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