Individual
AVA T LUCKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
602 SOUTH ST STE D-1, CHARDON, OH 44024-1499
(440) 285-3537
Mailing address
6753 STATE RD, PARMA, OH 44134-4517
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
S.0028788
OH
Other
Enumeration date
12/11/2019
Last updated
12/11/2019
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