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1578007415
LACY JACKSON
BALTIMORE, MD
NPI
1578007415
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: MD 07487)
Enumeration Date
2016-12-12
Last Update Date
2016-12-12
Business Address
-- LACY JACKSON
810 N CALVERT ST APT 6
BALTIMORE, MD 21202-3749
Phone number: 512-864-5221
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Mailing Address
-- LACY JACKSON
810 N CALVERT ST APT 6
BALTIMORE, MD 21202-3749
Phone number: 512-864-5221
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