Individual
ALIVIA MATEA LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
330 S DIXON RD STE 350, KOKOMO, IN 46901-5041
(765) 789-0564
Mailing address
336 WICKERSHAM DR W, KOKOMO, IN 46901-4004
(765) 398-5049
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
IN
Other
Enumeration date
01/05/2026
Last updated
01/05/2026
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