Individual
KIA LACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4 NESHAMINY INTERPLEX DR, SUITE 202, TREVOSE, PA 19053-6944
(215) 322-8860
Mailing address
4 NESHAMINY INTERPLEX DR, SUITE 202, TREVOSE, PA 19053-6944
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/27/2016
Last updated
07/27/2016
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