Individual
VIRGINIA LACEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISAC
Contact information
Practice address
3343 N WINDSONG DR, PRESCOTT VALLEY, AZ 86314-1213
(928) 445-5211
(928) 772-5444
Mailing address
3343 N WINDSONG DR, PRESCOTT VALLEY, AZ 86314-1213
(928) 445-5211
(928) 772-5444
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC0794
AZ
Other
Enumeration date
06/24/2015
Last updated
06/24/2015
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