Individual
WAYNENEISHA LACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11607 SOUTHFORK AVE # B, BATON ROUGE, LA 70816-5220
(504) 638-5127
Mailing address
10530 FLORDIA BLVD, 463, BATONE ROUGE, LA 70815
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/26/2023
Last updated
10/26/2023
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