Individual
MONICA SHAWNTAE LACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
150 KEN DWIGGINS DR, MOCKSVILLE, NC 27028-2439
(336) 751-1209
Mailing address
1064 KINGS MEADOW DR, WINSTON SALEM, NC 27127-4929
(704) 622-0296
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
10933
NC
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
03/16/2019
Last updated
07/25/2022
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