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1013643352
KELLI BETH LACY
LOGAN, WV
NPI
1013643352
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
(Licence: WV 21-913)
Enumeration Date
2022-07-28
Last Update Date
2022-07-28
Business Address
KELLI BETH LACY PRSS
509 MAIN ST
LOGAN, WV 25601-3809
Phone number: 304-896-5008
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Mailing Address
KELLI BETH LACY PRSS
509 MAIN ST
LOGAN, WV 25601-3809
Phone number: 304-896-5008
Copy
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