Individual
CASSIDY LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
522 E MAIN ST, MASCOUTAH, IL 62258-2240
(618) 566-0313
Mailing address
225 ALAMOSA DR, FREEBURG, IL 62243-2666
(330) 604-1262
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-226241
IL
Other
Enumeration date
07/25/2022
Last updated
07/25/2022
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