JEFFREY BLAKE LUCKETT

ROANOKE, VA
NPI1851482707
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy103TC0700X Psychologist Clinical
(Licence: VA  0810001414)
Enumeration Date2006-09-27
Last Update Date2012-01-11
Business Address
DR. JEFFREY BLAKE LUCKETT PHD
3635 MANASSAS DR
ROANOKE, VA 24018-4031
Phone number: 540-774-4686
Mailing Address
DR. JEFFREY BLAKE LUCKETT PHD
3635 MANASSAS DR
ROANOKE, VA 24018-4031
Phone number: 540-774-4686
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