Organization
LACEY REIKOWSKY, LPC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LACEY REIKOWSKY LPC (LICENSED PROFESSIONAL COUNSELOR)
(405) 401-5725
Entity
Organization
Contact information
Practice address
3000 UNITED FOUNDERS BLVD STE 148, OKLAHOMA CITY, OK 73112-4290
(405) 401-5725
Mailing address
620 SW 24TH ST, MOORE, OK 73160-5515
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
4300
OK
101YM0800X
Mental Health Counselor
4300
OK
101YP2500X
Professional Counselor
Primary
4300
OK
Other
Enumeration date
06/25/2015
Last updated
06/25/2015
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