Individual
STEPHANIE ALEXANDRA LUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4528 PLANK RD, FREDERICKSBURG, VA 22407-0141
(540) 841-4443
Mailing address
10506 ABBERLY VILLAGE LN APT 703, FREDERICKSBURG, VA 22407-2713
(540) 538-0466
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119008530
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0119008530
—
VA
Enumeration date
03/11/2020
Last updated
03/11/2020
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