Individual
KELLI ANNE LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
33 TOWER ST, SOMERVILLE, MA 02143-1426
(617) 591-4500
Mailing address
196 RIVERCHASE LN, MOORESVILLE, NC 28115-8336
(724) 531-5677
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4955
MA
Other
Enumeration date
06/17/2024
Last updated
06/17/2024
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