Individual
ETHEL LUKONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14115 LOVERS LN STE 154, CULPEPER, VA 22701-4158
(571) 237-7725
(757) 935-0240
Mailing address
12505 SHERWOOD FOREST DR, CULPEPER, VA 22701-1665
(571) 330-2402
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/18/2022
Last updated
05/18/2022
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