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LACEY JOHNSON
>> Developmental Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1538520994
Individual Registrant: LACEY JOHNSON
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
257 GLIMER MILLER ROAD LOWGAP, NC 27024 US
Tel: 336-858-0350 Fax: --
Tel: 336-858-0350 Fax: --
Contact information for business:
257 GLIMER MILLER ROAD LOWGAP, NC 27024 US
Tel: -- Fax: --
Tel: -- Fax: --
Registration Information:
NPI: 1538520994
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 222Q00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Developmental Therapist |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
