Individual
MR. DEREK LUCKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2831 N WHITE PINES DR, COEUR D ALENE, ID 83815-6259
(208) 640-3538
Mailing address
2831 N WHITE PINES DR, COEUR D ALENE, ID 83815-6259
(208) 640-3538
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/20/2009
Last updated
05/20/2009
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