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1326522434
TRISSTAN JA'VON LUCKETT
WINSTON SALEM, NC
NPI
1326522434
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: NC A12893)
Enumeration Date
2018-09-25
Last Update Date
2018-09-25
Business Address
TRISSTAN JA'VON LUCKETT NCC, LPCA
650 HIGHLAND AVE
WINSTON SALEM, NC 27101-4304
Phone number: 336-607-8523
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Mailing Address
TRISSTAN JA'VON LUCKETT NCC, LPCA
284 EXECUTIVE PARK DR STE 100
CONCORD, NC 28025-1833
Phone number: 704-939-1100
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