Individual
DANA LACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
4228 KADLEC DR, SHEBOYGAN, WI 53083-1782
(920) 459-8824
(920) 459-8825
Mailing address
4228 KADLEC DR, SHEBOYGAN, WI 53083-1782
(920) 459-8824
(920) 459-8825
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5406
WI
Other
Enumeration date
11/25/2014
Last updated
03/19/2015
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