Provider Demographics
NPI:1336459882
Name:LUKE, SHIRLEY JUNE (MED)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:JUNE
Last Name:LUKE
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 ROCK BLVD
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-4361
Mailing Address - Country:US
Mailing Address - Phone:775-355-7722
Mailing Address - Fax:775-355-7116
Practice Address - Street 1:835 ROCK BLVD
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-4361
Practice Address - Country:US
Practice Address - Phone:775-355-7722
Practice Address - Fax:775-355-7116
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor