Individual
ELMIRA NATISHSA LUCKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3117 NEWINGTON CT, NORTH CHESTERFIELD, VA 23224-5737
(804) 307-9249
Mailing address
2217 E FRANKLIN ST, RICHMOND, VA 23223-7046
(804) 213-0249
(804) 716-0715
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0710103212
VA
Other
Enumeration date
01/19/2018
Last updated
01/19/2018
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