DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

LACEY JACKSON

Active Sole Proprietor

LACEY JACKSON is a Behavior Technician healthcare provider located in LATHROP, Missouri. NPI 1669031514 is currently active in the NPPES registry. Verify at CMS.

Behavior Technician · LATHROP, MO

Registration Details

NPI Number
1669031514
Provider Type
Individual
Gender
Female
NPI Issued
Jun 12, 2019 (7.1585716442972 yrs)
Last Updated
Jun 12, 2019
Sole Proprietor
Yes

Practice Information

Address
124 LISA AVE
LATHROP, MO, 644659641
Browse MO providers · Browse ZIP 64465
Phone
8163983255
Primary Specialty
Behavior Technician
106S00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.