Provider Demographics
NPI:1457672115
Name:BOULIO-LUCIER, LUANN (LPC)
Entity Type:Individual
Prefix:
First Name:LUANN
Middle Name:
Last Name:BOULIO-LUCIER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 E 63RD ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4300
Mailing Address - Country:US
Mailing Address - Phone:912-344-9403
Mailing Address - Fax:912-354-3036
Practice Address - Street 1:515 E 63RD ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4300
Practice Address - Country:US
Practice Address - Phone:912-344-9403
Practice Address - Fax:912-354-3036
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005769101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional