Most Relevant Information
Provider Data
| NPI Number: | 1003320938 |
| Provider Name: | QUANICE LOCKE LCDCII |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | LCDCII.161603 |
Most Important Dates
| Enumeration Date: | 11/30/2017 |
| Last Updated: | 05/09/2022 |
Provider Practice Location
4977 NORTHCUTT PL
DAYTON
OH
454143839
Practice Location Phone/Fax
| Phone: | 9374507790 |
| Fax: |
Provider Mailing Location
615 ELSINORE PL STE 200
CINCINNATI
OH
452021459
Provider Mailing Phone/Fax
| Phone: | 5138347063 |
| Fax: | 5138731567 |