Individual
CAROLYN RENEE LACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
42105 W CHEYENNE DR, MARICOPA, AZ 85138-3356
(602) 319-8130
(520) 568-2709
Mailing address
42105 W CHEYENNE DR, MARICOPA, AZ 85138-3356
(602) 319-8130
(520) 568-2709
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
19802903
AZ
173000000X
Legal Medicine
Primary
19751503
AZ
247000000X
Health Information Technician
19662609
AZ
372600000X
Adult Companion
19591027
AZ
3747P1801X
Personal Care Attendant
19623108
AZ
374U00000X
Home Health Aide
19572204
AZ
Other
Enumeration date
10/01/2025
Last updated
10/01/2025
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