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Individual

MS. GIZELLA LUCCIO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CADC II & QMHP-C

Contact information

Practice address
328 S. CENTRAL AVE, SUITE 212, MEDFORD, OR 97501
(541) 944-0748
(541) 482-6462
Mailing address
165 TAYLOR AVE., TALENT, OR 97540
(541) 944-0748
(541) 779-3317

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12-09-620
OR
101YM0800X
Mental Health Counselor
19-QMNPC-00730
OR
101YP1600X
Pastoral Counselor
M.A.T.S.
CA
103K00000X
Behavior Analyst
819261
OR

Other

Enumeration date
01/06/2011
Last updated
03/26/2022
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