Individual
MALISA SHA'REE LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COSMETOLOGIST
Contact information
Practice address
5410 NC HIGHWAY 55, DURHAM, NC 27713-7800
(919) 638-7227
Mailing address
6123 GREENS HOLLOW LN, DURHAM, NC 27713-2109
(919) 638-7227
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C84271
NC
Other
Enumeration date
05/25/2012
Last updated
05/25/2012
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