Individual
DR. KATHLEEN LACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
11094 COUNTY ROAD 230, ORONOGO, MO 64855-8121
(405) 226-2572
Mailing address
11094 COUNTY ROAD 230, ORONOGO, MO 64855-8121
(405) 226-2572
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
1048
OK
103T00000X
Psychologist
Primary
2014039066
MO
103TC1900X
Counseling Psychologist
3526
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376612523
—
MO
05
—
200052450
—
OK
Enumeration date
11/06/2006
Last updated
04/05/2017
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