Individual
LACEY CASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2844 TRACELAND DR, TUPELO, MS 38801-4200
(662) 680-3148
(877) 276-4918
Mailing address
907 E WALKER ST, FULTON, MS 38843-8954
(662) 862-6140
(662) 862-6143
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S3657
MS
Other
Enumeration date
02/24/2015
Last updated
02/24/2015
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