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Individual

CATHERINE M LUCKHARDT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
1 MILL ST STE 206, BURLINGTON, VT 05401-1534
(802) 448-2028
Mailing address
1 MILL ST STE 206, BURLINGTON, VT 05401-1534

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
048.0134289
VT
103TC2200X
Clinical Child & Adolescent Psychologist
048.0134289
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100218268901
MA
05
6708640
VT
Enumeration date
07/30/2018
Last updated
12/02/2021
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