Provider Demographics
NPI:1598251738
Name:LUCIA, LAUREN MARIE (LAC, LMT)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:MARIE
Last Name:LUCIA
Suffix:
Gender:F
Credentials:LAC, LMT
Other - Prefix:MRS
Other - First Name:LAUREN
Other - Middle Name:LUCIA
Other - Last Name:REHORST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9555 S HOWELL AVE STE 700
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-5000
Mailing Address - Country:US
Mailing Address - Phone:414-975-2730
Mailing Address - Fax:
Practice Address - Street 1:9555 S HOWELL AVE STE 700
Practice Address - Street 2:
Practice Address - City:OAK CREEK
Practice Address - State:WI
Practice Address - Zip Code:53154-5000
Practice Address - Country:US
Practice Address - Phone:414-975-2730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-10
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI952171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist