Individual
MICHAEL SHANE LUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
61 WEST CENTER, SNOWFLAKE, AZ 85937
(480) 510-6780
Mailing address
2638 OLD SCHOOL HOUSE RD, SHOW LOW, AZ 85901-9433
(480) 510-6780
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-15864
AZ
Other
Enumeration date
12/22/2015
Last updated
12/26/2015
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