| NPI | 1790121119 |
|---|---|
| Former Name | STEPHANIE ANN LUCAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401014708) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401013543) |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2022-08-03 |