Individual
LAKEN LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6899 VIRGINIA AVE, PEMBROKE, VA 24136-3627
(540) 626-7281
Mailing address
650 LUCAS RD, NEWPORT, VA 24128-4115
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202011582
VA
Other
Enumeration date
08/20/2024
Last updated
08/20/2024
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