Individual
MRS. VIVIAN ELESA LASLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IECE SP. NEEDS ED
Contact information
Practice address
HWY 190 W, REECE SUBDIVISION, PINEVILLE, KY 40977
(606) 337-6107
(606) 248-6679
Mailing address
P.O. BOX 1035, PINEVILLE, KY 40977
(606) 337-6107
(606) 248-6679
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02015
PROVIDER ID NUMBER
KY
Enumeration date
05/09/2007
Last updated
07/26/2007
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