Individual
THELMA LAKETTIA LUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
302 N JACKSON ST, STARKVILLE, MS 39759-2504
(662) 323-9318
(662) 323-5553
Mailing address
302 N JACKSON ST, STARKVILLE, MS 39759-2504
(662) 323-9318
(662) 323-5553
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
W6672
MS
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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