Individual
MISS KAMEESHIA LACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
1703 MADISON ST, EVANSTON, IL 60202-2037
(312) 869-9482
Mailing address
PO BOX 6072, EVANSTON, IL 60204-6072
(312) 869-9482
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
02/01/2012
Last updated
02/01/2012
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