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Individual

JAYLON LACY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
16233 COPPER MOUNTAIN CIR, EAGLE RIVER, AK 99577-7704
(907) 891-6923
Mailing address
16233 COPPER MOUNTAIN CIR, EAGLE RIVER, AK 99577-7704
(907) 891-6923

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
09/29/2022
Last updated
09/29/2022
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