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1063280048
KELLY J LUCKEY
BLOOMINGTON, IL
NPI
1063280048
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: IL 180.002681)
Enumeration Date
2023-12-19
Last Update Date
2023-12-19
Business Address
KELLY J LUCKEY LCPC
1003 MARTIN LUTHER KING DR
BLOOMINGTON, IL 61701-1429
Phone number: 888-924-3786
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Mailing Address
KELLY J LUCKEY LCPC
448 WYLIE DR
NORMAL, IL 61761-5405
Phone number: 888-924-3786
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