Individual
LACEY HINTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2308 EDGELEA DR, LAFAYETTE, IN 47909
(765) 237-4589
Mailing address
2308 EDGELEA DR, LAFAYETTE, IN 47909-2509
(765) 237-4589
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
99063405A
IN
Other
Enumeration date
08/26/2014
Last updated
08/26/2014
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