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Individual

DR. MONICA BLANTON LACY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
2644 RIVA RD, ANNAPOLIS, MD 21401-7427
(410) 222-5000
Mailing address
701 SUMMERTIME DR, ODENTON, MD 21113-1591
(301) 502-8690

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
CER-152847-V9Z8S6
MD
103TS0200X
School Psychologist
DC

Other

Enumeration date
11/04/2013
Last updated
11/05/2024
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