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Individual

HAVEN LACKEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4141 DR MARTIN LUTHER KING JR BLVD, KANSAS CITY, MO 64130-3212
(816) 321-3299
Mailing address
4141 DR MARTIN LUTHER KING JR BLVD, KANSAS CITY, MO 64130-3212
(816) 321-3299

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2025043883
MO
133V00000X
Registered Dietitian
3426
KS

Other

Enumeration date
11/03/2025
Last updated
11/03/2025
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