Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | 1-18-31174 | |
Y | 102L00000X | Psychologist | 6301016938 | MI |
Y | 103T00000X | Psychologist | 6301016938 | MI |
N | 103TA0700X | Adult Development & Aging Psychologist | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
N | 103G00000X | Clinical Psychologist | 6301016938 | MI |
N | 103TC0700X | Clinical Psychologist | 6301016938 | MI |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | ||
N | 103TF0000X | Family Psychologist | ||
N | 103TM1800X | Intellectual & Developmental Disabilities | ||
N | 103TP2701X | Group Psychotherapist |
NPI | 1124458740 |
---|---|
Provider Name | Dr. Mary Luchies |
First Address | Big Rapids, MI 49307-9208 |
Second Address | Cadillac, MI 49601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2013 |
Last Update Date | 28/06/2018 |