| NPI | 1063196905 |
|---|---|
| Former Name | LACEY VATLAND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL APRN11027159) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL APRN11027159) |
| Enumeration Date | 2023-06-12 |
| Last Update Date | 2026-05-17 |