Individual
CHRISTINA LUCKE-SHIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
3015 W 31ST ST, LAWRENCE, KS 66047-3042
(785) 843-9262
Mailing address
1106 ELM ST, BALDWIN CITY, KS 66006-3038
(785) 760-2671
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
656
KS
Other
Enumeration date
02/25/2014
Last updated
02/25/2014
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