Individual
HANNAH LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
10750 W MCDOWELL RD STE A300, AVONDALE, AZ 85392-5963
(623) 399-6825
(623) 505-3474
Mailing address
18001 N 79TH AVE STE A12, GLENDALE, AZ 85308-8398
(623) 399-6825
(623) 505-3474
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86079779
TX
Other
Enumeration date
03/09/2021
Last updated
03/09/2021
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