Individual
LACEY ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RASAC I
Contact information
Practice address
103 S MAIN ST, SUITE C, KENNETT, MO 63857-3039
(573) 888-1844
(573) 888-6958
Mailing address
103 S MAIN ST, SUITE C, KENNETT, MO 63857-3039
(573) 888-1844
(573) 888-6958
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/21/2008
Last updated
11/21/2008
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