Tequila Jantana Lacy
Tequila Jantana Lacy is a Specialist in Jonesboro, Arkansas. Registered with an NPI since 2021.
- In the registry since
- 2021
- Specialties on file
- 2
Practice location Address checks out
2808 Fox Meadow LnJonesboro, AR 72404-9346
Phone: (870) 932-4245
Fax: (870) 931-4457
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Behavior Technician (primary) | Taxonomy 106S00000X |
|---|---|
| Specialist | Taxonomy 174400000X |
Record details
| NPI number | 1073187324 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | May 19, 2021 |
| Last updated in NPPES | June 3, 2024 |
| Certification date | November 22, 2023 |
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