Individual
MISS TERESA MARIE LUKASAVITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TLLP
Contact information
Practice address
1063 PROFESSIONAL DR # D4, FLINT, MI 48532-3636
(810) 496-4937
Mailing address
1410 S TELEGRAPH RD, BLOOMFIELD HILLS, MI 48302-0046
(248) 456-8150
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301015285
MI
Other
Enumeration date
06/18/2013
Last updated
06/18/2013
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