Individual
LACEY J LACOURSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
50 MONTCALM ST, TICONDEROGA, NY 12883-1393
(518) 585-7934
(518) 585-9132
Mailing address
77 WAYNE AVE, TICONDEROGA, NY 12883-1029
(518) 683-6832
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
589509
NY
163WA2000X
Administrator Registered Nurse
589509
NY
163WG0600X
Gerontology Registered Nurse
589509
NY
163WH1000X
Hospice Registered Nurse
589509
NY
Other
Enumeration date
05/24/2024
Last updated
05/24/2024
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