Individual
LACY LYNN GRANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
26877 N 87TH LN, PEORIA, AZ 85383-3716
(575) 302-8331
Mailing address
26877 N 87TH LN, PEORIA, AZ 85383-3716
(575) 302-8331
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
046846
AZ
Other
Enumeration date
09/14/2020
Last updated
09/14/2020
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