Lacie Gardner
Behavior Technician in Mobile, AL. Individual provider (NPI-1).
NPI number1982306148
StatusActive
Last updated in NPPESMar 21, 2023
Details
- NPI
- 1982306148
- Entity type
- Individual (NPI-1)
- Name
- Lacie Gardner
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 21, 2023
- Certification date
- Mar 21, 2023
- Last updated
- Mar 21, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
572 Azalea Rd Ste 100Mobile, AL 36609-1518
Phone 251-235-2531
Mailing address
24253 Alydar LoopDaphne, AL 36526-0330
Phone 334-524-1897
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