Provider Demographics
NPI:1134484132
Name:LACAVA, JACQUELINE (LOM)
Entity type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:
Last Name:LACAVA
Suffix:
Gender:
Credentials:LOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 134
Mailing Address - Street 2:
Mailing Address - City:VALLEY FORGE
Mailing Address - State:PA
Mailing Address - Zip Code:19481-0134
Mailing Address - Country:US
Mailing Address - Phone:610-790-3068
Mailing Address - Fax:
Practice Address - Street 1:1288 VALLEY FORGE RD STE 78
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-2687
Practice Address - Country:US
Practice Address - Phone:610-935-4434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-06
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK001020171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist