Search › Michigan › 163WA2000X
Jackie Lucas
NPI 1427602531 · on the registry since 2019 · sole proprietor
Practice
- Address
- 19270 Red Maple Ct
Southfield, MI 48076 - Phone
- (248) 296-1252
Registry record
- Primary taxonomy
- 163WA2000X
163WA2000X
- Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2019-07-26
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan