Individual
MRS. KATHLEEN MARIE LUCASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 OSWEGO ST, CAMDEN, NY 13316-1038
(315) 245-2616
Mailing address
1 OSWEGO ST, CAMDEN, NY 13316-1038
(315) 245-2616
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
010912-1
NY
Other
Enumeration date
11/10/2011
Last updated
12/20/2011
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