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Individual

HEATHER LUCAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LLP

Contact information

Practice address
31500 SCHOOLCRAFT RD, SUITE 100, LIVONIA, MI 48150-1805
(734) 422-9340
(734) 422-9353
Mailing address
12850 FOUNTAIN SQ, SUITE 106, DAVISBURG, MI 48350-2552
(248) 634-6303
(248) 634-1746

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301014385
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00260F7
HEALTH ALLIANCE PLAN
MI
01
750910401
BC CHRY
MI
01
XX19153
HEALTHPLUS
MI
Enumeration date
06/07/2011
Last updated
06/07/2011
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