Individual
MR. MICHAEL JOHN LUCIDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LLP
Contact information
Practice address
1 MACDONALD DR STE B, PETOSKEY, MI 49770-4406
(231) 347-6701
Mailing address
7228 CRYSTAL SPRINGS RD, BELLAIRE, MI 49615-9251
(313) 268-2471
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301012513
MI
Other
Enumeration date
03/10/2009
Last updated
03/10/2009
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