Individual
LACEY JAY DOTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
903 W MAIN ST, ANTLERS, OK 74523-2045
(580) 298-3001
(580) 298-5357
Mailing address
PO BOX 268, SULPHUR, OK 73086-0268
(580) 298-3001
(580) 298-5357
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
—
—
Other
Enumeration date
07/05/2012
Last updated
07/05/2012
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