Individual
BRENDA KAY LACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LD/N
Contact information
Practice address
153 SW LOBLOLLY PL, LAKE CITY, FL 32024-4247
(386) 752-2547
(386) 752-2547
Mailing address
153 SW LOBLOLLY PL, LAKE CITY, FL 32024-4247
(386) 752-2547
(386) 752-2547
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD4481
FL
Other
Enumeration date
01/25/2012
Last updated
01/25/2012
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