Individual
REBECCA LACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 HOSPITAL ST, MOULTON, AL 35650-1268
(256) 974-1146
Mailing address
300 HOSPITAL ST, MOULTON, AL 35650-1268
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2935
AL
Other
Enumeration date
10/11/2016
Last updated
10/11/2016
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