| NPI | 1588997753 |
|---|---|
| Former Name | ALICIA LUCKEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AZ 4621) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AZ 4621) |
| Enumeration Date | 2009-09-04 |
| Last Update Date | 2024-09-03 |