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1164998928
LACY BOUTWELL
WARNER ROBINS, GA
NPI
1164998928
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: GA SLP008941)
Enumeration Date
2018-10-19
Last Update Date
2018-10-19
Business Address
LACY BOUTWELL
524 S HOUSTON LAKE RD STE B300
WARNER ROBINS, GA 31088-9042
Phone number: 678-910-3940
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Mailing Address
LACY BOUTWELL
107 GRAND VIEW AVE
KATHLEEN, GA 31047-2747
Phone number: 678-910-3940
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