Individual
MS. LACEY JEAN LEAF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
1617 RAMIREZ ST, MARYSVILLE, CA 95901-4334
(530) 742-7311
Mailing address
1617 RAMIREZ ST, MARYSVILLE, CA 95901-4334
(530) 742-7311
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2002
CA
Other
Enumeration date
03/08/2016
Last updated
03/08/2016
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