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Individual

MARIANNA M. LUCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
710 S BRANDYWINE ST, WEST CHESTER, PA 19382-3511
(610) 692-3456
Mailing address
857 CHANDLEE DR, WEST CHESTER, PA 19382-1979
(610) 692-7088
(610) 692-0876

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS-005833-L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0536119000
MHS PROVIDER NO.
PA
Enumeration date
05/31/2007
Last updated
10/03/2012
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