Individual
MISS STACEY NICHOLE LUSK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT-BC, DT
Contact information
Practice address
40W310 LAFOX RD, SUITE 1A, ST CHARLES, IL 60175-6588
(630) 444-0077
Mailing address
746 N GLENWOOD PL, AURORA, IL 60506-1908
(630) 546-0380
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
—
—
Other
Enumeration date
02/15/2007
Last updated
07/08/2007
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