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Individual

DR. ELLEN BARBARA LUCAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
707 W UNIVERSITY AVE, MUNCIE, IN 47303-3865
(765) 254-9343
Mailing address
PO BOX 444, MUNCIE, IN 47308-0444
(765) 254-9343

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
20040571
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20040572
LICENSE NUMBER
IN
Enumeration date
06/29/2006
Last updated
07/08/2007
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