Individual
KATHLEEN M LACSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
832 HANSHAW RD FL 2, ITHACA, NY 14850-1548
(917) 887-0031
(607) 793-6149
Mailing address
832 HANSHAW RD FL 2, ITHACA, NY 14850-1548
(917) 887-0031
(607) 793-6149
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F401607-1
NY
367500000X
Certified Registered Nurse Anesthetist
430739-1
NY
Other
Enumeration date
02/15/2006
Last updated
02/12/2024
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