Most Relevant Information
Provider Data
| NPI Number: | 1003439126 |
| Provider Name: | EMILY JOHANNA LUCASSIAN |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/22/2020 |
| Last Updated: | 12/15/2021 |
Provider Practice Location
1225 S LATSON RD
HOWELL
MI
488437643
Practice Location Phone/Fax
| Phone: | 5173382370 |
| Fax: |
Provider Mailing Location
1225 S LATSON RD
HOWELL
MI
488437643
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |