Individual
JACQUELYN LUCIDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
19176 HALL RD, CLINTON TWP, MI 48038
(800) 379-1600
Mailing address
61658 COTSWOLD DR, WASHINGTON, MI 48094-1073
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201010242
MI
Other
Enumeration date
08/29/2018
Last updated
11/25/2019
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