Individual
LACEY KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1940 E CHAPPELL RD, MC CONNELLS, SC 29726-8758
(203) 258-0250
Mailing address
1940 E CHAPPELL RD, MC CONNELLS, SC 29726-8758
(203) 258-0250
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
325956
SC
Other
Enumeration date
05/21/2026
Last updated
05/21/2026
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