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NPI Code Detail

MEDICARE: MELODY LUCAS

MEDICARE: MELODY LUCAS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1558762708
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELODY LUCAS
Provider Business Mailing Address
First Line : 1000 MULLER AVE
Second Line :
City : COLUMBIA
State : SC
Zip : 29203-5813
Country : US
Telephone Number : 803-309-3399
Fax Number :
Provider Business Practice Location Address
First Line : 1000 MULLER AVE
Second Line :
City : COLUMBIA
State : SC
Zip : 29203-5813
Country : US
Telephone Number : 803-309-3399
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2014
Last Update Date : 03/01/2020

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Directions to “ MELODY LUCAS ” Practice Location

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