Individual
MR. DALE RAY LACY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MENTAL HEALTH WORKER
Contact information
Practice address
3147 N MILLBROOK AVE, FRESNO, CA 93703-1425
(559) 453-3860
Mailing address
3147 N MILLBROOK AVE, FRESNO, CA 93703-1425
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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