Individual
MARTELA CARRON LACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
1315 13TH AVE SE, DECATUR, AL 35601-4308
(256) 260-7306
(256) 350-5664
Mailing address
1316 SOMERVILLE RD SE STE 1, DECATUR, AL 35601-4309
(256) 260-7361
(256) 350-5664
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/20/2018
Last updated
02/20/2018
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