Individual
KADDI LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
4950 W 23RD ST STE 1, ERIE, PA 16506-5802
(814) 456-2755
(814) 456-4873
Mailing address
419 WATERFORD ST, EDINBORO, PA 16412-5517
(814) 734-5021
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
TOC103210
PA
Other
Enumeration date
06/02/2016
Last updated
03/17/2018
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