Individual
KIANNA JANAE LACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
17516 MATANY RD STE 100, JUSTIN, TX 76247-8707
(940) 654-4011
(844) 440-2104
Mailing address
3909 N LOOP 288 APT 3302, DENTON, TX 76208-7707
(817) 727-3071
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
124732
TX
Other
Enumeration date
07/17/2024
Last updated
07/17/2024
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