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Individual

GAYLA REGINA LUCAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
228 MAIN ST E, AHOSKIE, NC 27910-3418
(252) 209-0388
(252) 209-0488
Mailing address
PO BOX 885, AHOSKIE, NC 27910-0885
(252) 209-0388
(252) 209-0488

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3486
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
142CA
BLUE CROSS- BLUE SHIELD
NC
05
6107259
NC
Enumeration date
02/13/2007
Last updated
07/08/2007
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