Individual
EMILY JOHANNA LUCASSIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15717 15 MILE RD, CLINTON TWP, MI 48035-2101
(586) 285-3800
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450
(313) 874-4806
(313) 876-1305
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601010141
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/22/2020
Last updated
03/03/2025
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