Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 682 | NH |
Y | 103TC0700X | Clinical Psychologist | 682 | NH |
NPI | 1013027481 |
---|---|
Provider Name | Donna Lucas |
First Address | Concord, NH 03302-2032 |
Second Address | Concord, NH 03301-2551 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |