Provider Information for 1508631292
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GAJENDRANATH LUCKHOO LMHC
Other Names:Other Name:GAVIN LUCKHOOSex: Male
NPI: 1508631292
Last Updated: 2023-11-22
Certification Date: 2023-11-22
Certification Date: 2023-11-22
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1508631292 | ||||||||
| Enumeration Date | 2023-11-22 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 13329 SUNSET SAPPHIRE CT PARRISH, FL 34219-2495 United States Phone: 954-245-9382 | Fax: | ||||||||
| Primary Practice Address | 13329 SUNSET SAPPHIRE CT PARRISH, FL 34219-2495 United States Phone: 954-245-9382 | Fax: | ||||||||
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