Individual
JESSICA ROSE LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1028 LOTTS CREEK RD, HAZARD, KY 41701
(606) 438-4582
Mailing address
PO BOX 615, BULAN, KY 41722-0615
(606) 438-4582
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
222Q00000X
Developmental Therapist
Primary
201115741
KY
Other
Enumeration date
02/21/2008
Last updated
08/22/2014
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