Most Relevant Information
Provider Data
| NPI Number: | 1003505710 |
| Provider Name: | AHLEXCIS KRISTIAN LACKEY |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/08/2023 |
| Last Updated: | 05/08/2023 |
Provider Practice Location
1001 W SW LOOP 323
TYLER
TX
757019416
Practice Location Phone/Fax
| Phone: | 4302058710 |
| Fax: |
Provider Mailing Location
1001 W SW LOOP 323
TYLER
TX
757019416
Provider Mailing Phone/Fax
| Phone: | 4302058710 |
| Fax: |