Individual
TASHANTE LUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9307 S 27TH ST, FRANKLIN, WI 53132-9162
(414) 808-4262
Mailing address
9307 S 27TH ST, FRANKLIN, WI 53132-9162
(414) 808-4262
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
10/17/2025
Last updated
10/17/2025
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