Individual
LACEY PIKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1912 N MAIN ST, DAYTON, OH 45405-3801
(326) 213-0264
Mailing address
800 WAGON WHEEL DR, DAYTON, OH 45431-2739
(326) 213-0264
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/02/2026
Last updated
04/02/2026
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