William Lacy Jr.
Marriage & Family Therapist in Kankakee, IL. Individual provider (NPI-1).
NPI number1164079026
StatusActive
Last updated in NPPESSep 3, 2019
Details
- NPI
- 1164079026
- Entity type
- Individual (NPI-1)
- Name
- William Lacy Jr.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 24, 2019
- Last updated
- Sep 3, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 208000719 | IL | Yes |
Practice location
187 S Schuyler Ave Ste 555Kankakee, IL 60901-3825
Phone 815-304-4726 · Fax 815-304-4749
Mailing address
187 S Schuyler Ave Ste 555Kankakee, IL 60901-3825
Phone 815-304-4726 · Fax 815-304-4749
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