Individual
DR. LACY MARIE DEITRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
4301 WILSON ST, FORT SILL, OK 73503-4472
(817) 823-1566
Mailing address
4301 WILSON ST, FORT SILL, OK 73503-4472
(817) 823-1566
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31007304A
IN
Other
Enumeration date
02/23/2022
Last updated
03/20/2025
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