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1174682504
PHYLLIS J LACKEY
XENIA, OH
NPI
1174682504
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
(Licence: OH C0003153)
Enumeration Date
2006-12-08
Last Update Date
2007-07-08
Business Address
-- PHYLLIS J LACKEY Lic Prof Counselor
482 N DETROIT ST
XENIA, OH 45385
Phone number: 937-374-6010
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Mailing Address
-- PHYLLIS J LACKEY Lic Prof Counselor
76 FORDWAY DR SUITE 2
VANDALIA, OH 45377
Phone number: 937-890-3139
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