Individual
LEESA LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3535 NW 58TH ST., SUITE 870, OKC, OK 73112
(405) 702-9032
Mailing address
3121 NW 54TH ST, OKLAHOMA CITY, OK 73112-5308
(405) 205-8326
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/03/2010
Last updated
02/03/2010
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