Individual
LUXTRACIA GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
34 W QUEENS WAY, HAMPTON, VA 23669-3968
(757) 703-3621
Mailing address
34 W QUEENS WAY, HAMPTON, VA 23669-3968
(757) 703-3621
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701006572
VA
Other
Enumeration date
05/10/2016
Last updated
10/15/2019
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