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Individual

SUSAN H LUCCHESE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OYR/L

Contact information

Practice address
2532 W INDIANTOWN RD STE 2, JUPITER, FL 33458-3935
(561) 748-5430
(561) 748-5442
Mailing address
8906 FIRST TEE RD, PORT ST LUCIE, FL 34986-3065
(772) 288-0196
(561) 748-5442

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT9092
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
885115800
FL
Enumeration date
08/30/2006
Last updated
07/31/2008
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