Organization
PBS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HASSAN LUCAS (ASSISTANT)
(484) 645-5975
Entity
Organization
Contact information
Practice address
3630 RANCH RD, COLUMBIA, SC 29206-5252
(484) 645-5975
Mailing address
3630 RANCH RD, COLUMBIA, SC 29206-5252
(484) 645-5975
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
11/07/2025
Last updated
11/07/2025
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