Provider Demographics
NPI:1386185122
Name:KAFER, LACEY (OTR)
Entity Type:Individual
Prefix:
First Name:LACEY
Middle Name:
Last Name:KAFER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7002 RIVERBROOK DR
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-6530
Mailing Address - Country:US
Mailing Address - Phone:281-343-7125
Mailing Address - Fax:
Practice Address - Street 1:7002 RIVERBROOK DR
Practice Address - Street 2:SUITE 500
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-6530
Practice Address - Country:US
Practice Address - Phone:281-343-7125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-13
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117396225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist