Phyllis J Lackey, LIC PROF COUNSELOR

NPI #1174682504 in Xenia, Ohio

Provider Information

NPI Number: 1174682504
Entity Type: Individual
Name: Phyllis J Lackey, LIC PROF COUNSELOR
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor
Credential: LIC PROF COUNSELOR
Enumeration Date: Dec 8, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 482 N DETROIT ST
City: Xenia
State: Ohio
ZIP Code: 45385
Phone: (937) 374-6010

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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