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1861960023
RYAN DEXTER LACY
OAKLAND, CA
NPI
1861960023
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
101Y00000X Counselor
Enumeration Date
2018-11-06
Last Update Date
2024-03-08
Business Address
Mr. RYAN DEXTER LACY
390 40TH ST
OAKLAND, CA 94609-2633
Phone number: 510-613-0330
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Mailing Address
Mr. RYAN DEXTER LACY
390 40TH ST
OAKLAND, CA 94609-2633
Phone number: 510-613-0330
Copy
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