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General NPI Number Information
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NPI Number | 1497068209
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Entity Type | Individual
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Provider Name | ALEXIS LILLIE LUCAS MS, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 07/21/2010
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Last Update Date | 12/23/2020
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Provider Practice Location Address
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Address Line | 4560 PRINCESS ANNE RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-7905
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Country | US
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Telephone | 757-474-1249
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Fax | 757-474-0193
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Provider Business Mailing Address
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Address Line | 1130 FALLS RIVER AVE
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City | RALEIGH
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State | NC
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Zip | 27614-7772
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Country | US
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Telephone | 919-803-2912
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Fax | 919-803-3027
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 7381
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License Number State | NC
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