Individual
CATHERINE M LUCKHARDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
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
Update your record
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