Individual
DEJA AMARI LACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
780 LYNNHAVEN PKWY STE 400, VIRGINIA BEACH, VA 23452-7332
(877) 276-0626
Mailing address
46 WASHINGTON AVE STE 1, SUFFERN, NY 10901-5608
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-270420
—
Other
Enumeration date
01/02/2025
Last updated
01/27/2025
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