Individual
DR. LARISSA MARY LUCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DHSC IBCLC RD
Contact information
Practice address
7719 SOUNDERS TRL, MYRTLE BEACH, SC 29588-6616
(781) 690-0445
Mailing address
7719 SOUNDERS TRL, MYRTLE BEACH, SC 29588-6616
(781) 690-0445
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
174N00000X
Lactation Consultant (Non-RN)
Primary
L-108178
—
Other
Enumeration date
11/06/2007
Last updated
11/15/2023
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