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Individual

DR. RACHEL KELLI LACY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
1805 HERRINGTON RD, BUILDING 3, STE. 3-B, LAWRENCEVILLE, GA 30043-7987
(770) 722-7827
(770) 760-0624
Mailing address
PO BOX 58, FLOWERY BRANCH, GA 30542-0001
(770) 722-7827
(770) 962-1886

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY002801
GA
103TA0700X
Adult Development & Aging Psychologist
PSY002801
GA
103TB0200X
Cognitive & Behavioral Psychologist
PSY002801
GA
103TC0700X
Clinical Psychologist
PSY002801
GA
103TF0200X
Forensic Psychologist
PSY002801
GA
103TH0004X
Health Psychologist
PSY002801
GA
103TM1800X
Intellectual & Developmental Disabilities Psychologist
PSY002801
GA
103TR0400X
Rehabilitation Psychologist
PSY002801
GA

Other

Enumeration date
05/19/2007
Last updated
10/29/2018
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