Doctor Name: | MRS. JACQUELINE A LUCKE |
NPI Number: | 1457489023 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCCSLP |
License Number: | SA 2731 |
Business Practice Address: | 11202 Se 54th Ave Belleview, FL - 344203959 |
Business Phone Number: | 3523474380 |
Business Fax Number: | 3523474380 |
Mailing Address: | Po Box 830441, OCALA |
State: | FL |
Postal Code: | 344830441 |
Phone Number: | 3523474380 |
Fax Number: | 3523474380 |
NPI Enumeration Date: | 03/02/2007 |
NPI Last Update Date: | 07/23/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA 2731 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |