| Doctor Name: | MONICA BLANTON LACY |
| NPI Number: | 1346679081 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | |
| Business Practice Address: | 701 Summertime Dr Odenton, MD - 211131591 |
| Business Phone Number: | 3015028690 |
| Business Fax Number: | |
| Mailing Address: | 701 Summertime Dr, ODENTON |
| State: | MD |
| Postal Code: | 211131591 |
| Phone Number: | 3015028690 |
| Fax Number: | |
| NPI Enumeration Date: | 11/04/2013 |
| NPI Last Update Date: | 11/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TS0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | DC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |