Luecke, Samantha
Luecke, Samantha is an individual health care provider with primary practice located at 4770 Baseline Rd Ste 200 , Boulder CO 80303-2668. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Luecke, Samantha can be contacted via phone (970) 682-3476.Contact Information
Primary practice address
4770 Baseline Rd Ste 200
Boulder CO 80303-2668
Phone: (970) 682-3476
Fax: (855) 568-2494
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavior Technician | 106S00000X |
Profile Details
| NPI number | 1104590918 |
|---|---|
| LBN Legal business name | Luecke, Samantha |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 4th, 2021 |
| Last updated | Aug 4th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104590918 | NPPES |
| Kentucky | Other | L14527584 | DRIVER LICENSE |
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