Provider Demographics
NPI:1588082705
Name:LUCAS, LESHA
Entity type:Individual
Prefix:
First Name:LESHA
Middle Name:
Last Name:LUCAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6948 DUNSBACH WAY APT B
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89156-6119
Mailing Address - Country:US
Mailing Address - Phone:888-906-9929
Mailing Address - Fax:888-892-3669
Practice Address - Street 1:6948 DUNSBACH WAY APT B
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89156-6119
Practice Address - Country:US
Practice Address - Phone:888-906-9929
Practice Address - Fax:888-892-3669
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-03
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner