Individual
MARILYN DIANNE LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
10129 KINGS TABLE DR, INDIANAPOLIS, IN 46229-1350
(317) 891-2390
Mailing address
10129 KINGS TABLE DR, INDIANAPOLIS, IN 46229-1350
(317) 891-2390
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39002164A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100270530
—
IN
Enumeration date
01/17/2008
Last updated
04/09/2013
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