Individual
MRS. BONNIE T LUCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
120 RANDOM OAKS LN, MANDEVILLE, LA 70448-4565
(985) 624-9956
(985) 624-9956
Mailing address
120 RANDOM OAKS LN, MANDEVILLE, LA 70448-4565
(985) 624-9956
(985) 624-9956
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
Z10451
LA
Other
Enumeration date
07/22/2005
Last updated
08/08/2007
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