Individual
MS. ALLISON LEE LACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
567 N AND SOUTH RD APT C, SAINT LOUIS, MO 63130-3939
(314) 380-3088
Mailing address
500 E BEAR BLVD APT B, SPRINGFIELD, MO 65806-3582
(636) 614-9543
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-17-41531
MO
225X00000X
Occupational Therapist
Primary
2022010049
MO
Other
Enumeration date
09/17/2018
Last updated
05/13/2022
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