Provider Demographics
NPI:1427747377
Name:MCGEE, LACIE
Entity type:Individual
Prefix:
First Name:LACIE
Middle Name:
Last Name:MCGEE
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 1:1005 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:LOUP CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68853-8215
Mailing Address - Country:US
Mailing Address - Phone:308-745-0303
Mailing Address - Fax:
Practice Address - Street 1:1005 N EIGHTH STREET
Practice Address - Street 2:
Practice Address - City:LOUP CITY
Practice Address - State:NE
Practice Address - Zip Code:68853
Practice Address - Country:US
Practice Address - Phone:308-745-0303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1136224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant