Individual
DR. CAROL LACEY RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4316 LAKE STONE TRL, FORT WORTH, TX 76123-8009
(817) 542-2595
Mailing address
4316 LAKE STONE TRL, FORT WORTH, TX 76123-8009
(817) 542-2595
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
35034
TX
Other
Enumeration date
03/27/2012
Last updated
03/27/2012
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