Individual
LACI NICOLE ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
130 WESTWOODS DR, LIBERTY, MO 64068-1181
(816) 382-1513
Mailing address
6449 MARTIN DR, AGENCY, MO 64401-9112
(816) 382-1513
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2021017916
MO
Other
Enumeration date
02/11/2022
Last updated
06/17/2024
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