Individual
AFRICA MARQUITIA LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SAC-IT
Contact information
Practice address
23 W SCOTT ST, FOND DU LAC, WI 54935-2342
(920) 926-0101
Mailing address
10421 W. HAMPTON AVE APT #3, MILWAUKEE, WI 53225
(414) 687-0432
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17939-130
WI
Other
Enumeration date
02/15/2019
Last updated
02/15/2019
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