IndividualActive
Lacie House, RSA
NPI 1578112736 · Rehabilitation Practitioner · Waterloo, IL
Provider details
- NPI number
- 1578112736
- Entity type
- Individual
- Primary specialty
- Rehabilitation PractitionerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- RSA
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
988 N Illinois Route 3
Waterloo, IL 62298-1059
Phone: (618) 939-4444
Approximate (ZIP-level) locationGet directions
Mailing address
988 N Illinois Route 3
Waterloo, IL 62298-1059
Registry dates
- Enumerated
- 2019-09-10
- Last updated
- 2019-09-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.