Provider Demographics
NPI:1154644102
Name:LUCAS, JOANNE S (COTA)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:S
Last Name:LUCAS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:898 9TH CT
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-5344
Mailing Address - Country:US
Mailing Address - Phone:219-947-3850
Mailing Address - Fax:
Practice Address - Street 1:898 9TH CT
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-5344
Practice Address - Country:US
Practice Address - Phone:219-947-3850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32001168A224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant