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1093130262
CHRISTINA LUCKE-SHIVELY
LAWRENCE, KS
NPI
1093130262
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: KS 656)
Enumeration Date
2014-02-25
Last Update Date
2014-02-25
Business Address
-- CHRISTINA LUCKE-SHIVELY LAC
3015 W 31ST ST
LAWRENCE, KS 66047-3042
Phone number: 785-843-9262
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Mailing Address
-- CHRISTINA LUCKE-SHIVELY LAC
1106 ELM ST
BALDWIN CITY, KS 66006-3038
Phone number: 785-760-2671
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