Provider Demographics
NPI:1922533496
Name:HOWELL, LACEY
Entity Type:Individual
Prefix:
First Name:LACEY
Middle Name:
Last Name:HOWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 N CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-7306
Mailing Address - Country:US
Mailing Address - Phone:918-402-0868
Mailing Address - Fax:
Practice Address - Street 1:1015 N CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-7306
Practice Address - Country:US
Practice Address - Phone:918-402-0868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-21
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator