Individual
LUCILLE ANN NEWTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1595 S CALUMET RD STE 3, CHESTERTON, IN 46304-2389
(219) 764-4888
(219) 898-4258
Mailing address
PO BOX 283, BROOKLYN, IN 46111
(317) 910-5118
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200196020A
—
IN
Enumeration date
06/24/2019
Last updated
06/17/2020
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