Individual
MS. BOBBIE B. LACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED EDS
Contact information
Practice address
1500 LADY STREET, COLUMBIA, SC 29201
(803) 779-1995
(803) 779-7881
Mailing address
1500 LADY STREET, COLUMBIA, SC 29201
(803) 779-1995
(803) 779-7881
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2655
SC
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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