Individual
DR. KANDISE LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.A, MSED, PHD
Contact information
Practice address
10906 SASSAFRAS DR, NORTH PRINCE GEORGE, VA 23860-7607
(804) 248-8656
Mailing address
10905 SASSAFRAS DR, NORTH PRINCE GEORGE, VA 23860-7606
(804) 248-8656
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
—
—
171400000X
Health & Wellness Coach
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251B00000X
Case Management Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
372500000X
Chore Provider
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
03/18/2024
Last updated
03/18/2024
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