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Individual

DR. MARY LUCHIES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD, LP

Contact information

Practice address
200 W CASS ST, SAINT JOHNS, MI 48879-1807
(231) 598-0433
Mailing address
200 W CASS ST, SAINT JOHNS, MI 48879-1807
(231) 598-0433

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-18-31174
103T00000X
Psychologist
6301016938
MI
103TA0700X
Adult Development & Aging Psychologist
103TB0200X
Cognitive & Behavioral Psychologist
103TC0700X
Clinical Psychologist
Primary
6301016938
MI
103TC2200X
Clinical Child & Adolescent Psychologist
103TF0000X
Family Psychologist
103TM1800X
Intellectual & Developmental Disabilities Psychologist
103TP2701X
Group Psychotherapy Psychologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
CV0082156
MI
Enumeration date
11/18/2013
Last updated
08/11/2022
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