Tequila Jantana Lacy

NPI #1073187324 in Jonesboro, Arkansas

Provider Information

NPI Number: 1073187324
Entity Type: Individual
Name: Tequila Jantana Lacy
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: May 19, 2021
Last Updated: Jun 3, 2024

Practice Location

Address: 2808 FOX MEADOW LANE
City: Jonesboro
State: Arkansas
ZIP Code: 72404-9346
Phone: (870) 932-4245

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X
Behavior Technician	106S00000X	Primary

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