Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 4096 | NC |
Y | 103TC0700X | Clinical Psychologist | 4096 | NC |
N | 103G00000X | Clinical Psychologist | 4096 | NC |
N | 103TC0700X | Clinical Psychologist | 4096 | NC |
N | 103TH0100X | Health Service | 4096 | NC |
N | 103TR0400X | Rehabilitation Psychologist | 4096 | NC |
NPI | 1124313796 |
---|---|
Provider Name | Dr. Luchy Julia Secaira |
First Address | Naples, FL 34108-2441 |
Second Address | Naples, FL 34108-2441 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2011 |
Last Update Date | 29/12/2011 |