Individual
STACEY LUCHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSCCCSLP
Contact information
Practice address
1207 PRAIRIE PKWY, STE. A, WEST FARGO, ND 58078-3145
(701) 356-0062
(701) 356-5412
Mailing address
1207 PRAIRIE PKWY, SUITE A, WEST FARGO, ND 58078-3145
(701) 356-0062
(701) 356-5412
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
698
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51417
—
ND
01
—
LUC27448
BCBS ND PROVIDER NUMBER
ND
Enumeration date
01/02/2007
Last updated
03/11/2008
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