Individual
LACY IAKOVAKIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
321 E MAIN ST, CUSHING, OK 74023-2643
(918) 285-6268
Mailing address
321 E MAIN ST, CUSHING, OK 74023-2643
(512) 924-9904
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
06/30/2020
Last updated
07/30/2020
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