Ryan Lucas
Peer Specialist in Willoughby, OH. Individual provider (NPI-1).
NPI number1669021077
StatusActive
Last updated in NPPESSep 9, 2019
Details
- NPI
- 1669021077
- Entity type
- Individual (NPI-1)
- Name
- Ryan Lucas
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 9, 2019
- Last updated
- Sep 9, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 175T00000X | Peer Specialist | – | – | Yes |
Practice location
38882 Mentor AveWilloughby, OH 44094-7875
Phone 440-578-8200
Mailing address
38882 Mentor AveWilloughby, OH 44094-7875
Phone 440-578-8200
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