Individual
DANIELLE LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC/SLP
Contact information
Practice address
28046 WATSON RD, DEFIANCE, OH 43512-8851
(419) 395-1111
Mailing address
9650 STATE ROUTE 613, LEIPSIC, OH 45856-9417
(419) 969-4386
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP.11900
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14089193
ASHA
—
01
—
SP.11900
OHIO SLP
OH
Enumeration date
01/30/2023
Last updated
01/30/2023
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