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Individual

DONNA M LUCAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.D,L.D.

Contact information

Practice address
269 S CANDY LN, COTTONWOOD, AZ 86326-4158
(928) 639-6543
(928) 639-6340
Mailing address
1200 N. BEAVER, PAYER CREDENTIALING, FLAGSTAFF, AZ 86004
(928) 213-6235
(928) 213-6292

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1142
OH
133V00000X
Registered Dietitian
614026
AZ

Other

Enumeration date
12/29/2006
Last updated
03/16/2017
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