Individual
CECELIA ROSETTA LACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
4520 LEXINGTON AVE, SAINT LOUIS, MO 63115-2340
(314) 652-0867
Mailing address
4520 LEXINGTON AVE, SAINT LOUIS, MO 63115-2340
(314) 652-0867
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043232
MO
Other
Enumeration date
08/01/2011
Last updated
08/01/2011
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