Individual
MS. GLORIA R LUCKER
Active
Individual
MS. GLORIA R LUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
000209-1
NY
225XP0200X
Pediatric Occupational Therapist
00209-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000670000002
COMMUNITY BLUE
NY
05
—
01807827
—
NY
Enumeration date
10/11/2006
Last updated
03/31/2008
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