Individual
LARRY G. LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
1221 N KINGSHIGHWAY ST, IMPERIAL BUILDING, CAPE GIRARDEAU, MO 63701-3506
(573) 335-7929
(573) 335-6445
Mailing address
PO BOX 645, CAPE GIRARDEAU, MO 63702-0645
(573) 335-7929
(573) 335-6445
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2006033651
MO
Other
Enumeration date
01/04/2008
Last updated
01/04/2008
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