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LATOYA MICHELLE LUCAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNA

Contact information

Practice address
432 KINGSTON DR, MC BEE, SC 29101-9568
(843) 861-5197
Mailing address
432 KINGSTON DR, MC BEE, SC 29101-9568
(843) 861-5197

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
129296
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8433197330
SC
Enumeration date
09/12/2022
Last updated
09/12/2022
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