Individual
JAMES OTTO LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISAC
Contact information
Practice address
2080 ACOMA BLVD W UNIT A, LAKE HAVASU CITY, AZ 86403-2971
(928) 821-2424
Mailing address
2080 ACOMA BLVD W UNIT A, LAKE HAVASU CITY, AZ 86403-2971
(928) 453-8003
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC10723
AZ
Other
Enumeration date
11/20/2018
Last updated
11/20/2018
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