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1427697366
BLAKE ANTHONY LUCAS
LEMON GROVE, CA
NPI
1427697366
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2019-12-23
Last Update Date
2019-12-23
Business Address
BLAKE ANTHONY LUCAS
2049 SKYLINE DR
LEMON GROVE, CA 91945-4221
Phone number: 619-465-7303
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Mailing Address
BLAKE ANTHONY LUCAS
1400 N JOHNSON AVE STE 101
EL CAJON, CA 92020-1651
Phone number: 619-442-0277
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