Individual
LYDIA MISCHA LACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA.CCC.SLP
Contact information
Practice address
342 MCCOOK CIR NW, KENNESAW, GA 30144-3157
(810) 499-2767
Mailing address
342 MCCOOK CIR NW, KENNESAW, GA 30144-3157
(810) 499-2767
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP008693
GA
Other
Enumeration date
03/08/2018
Last updated
12/03/2018
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