Individual
DR. EDNA DENISE LACKEY
Active
Individual
DR. EDNA DENISE LACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN MBA PH.D
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
CA
101YP1600X
Pastoral Counselor
—
OH
163WA2000X
Administrator Registered Nurse
Primary
RN-257326
OH
163WD0400X
Diabetes Educator Registered Nurse
RN-257326
OH
174H00000X
Health Educator
RN-257326
OH
Other
Enumeration date
07/09/2014
Last updated
07/16/2014
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