Individual
TIERRA VICTORIA LUTTRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1212 W LOMBARD ST, SPRINGFIELD, MO 65806-2720
(417) 983-7600
Mailing address
3639 E BOWMAN ST, SPRINGFIELD, MO 65809-3420
(573) 286-2449
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2022014071
MO
Other
Enumeration date
07/28/2022
Last updated
07/28/2022
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