Individual
LUCAS ALCANTARA WASHINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RBT, CTRS
Contact information
Practice address
402B LEGACY PARK, RIDGELAND, MS 39157-4315
(769) 233-7154
Mailing address
402B LEGACY PARK, RIDGELAND, MS 39157-4315
(769) 233-7154
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-89653
MS
225800000X
Recreation Therapist
64000
MS
Other
Enumeration date
03/23/2022
Last updated
03/23/2022
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