Individual
LACY WELCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2106 W MAIN ST, BOWLING GREEN, MO 63334-1049
(877) 787-3430
Mailing address
2600 COMPASS RD, GLENVIEW, IL 60026-8001
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2016034408
MO
Other
Enumeration date
07/11/2023
Last updated
07/11/2023
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