Provider Demographics
NPI:1134972169
Name:LUTHER, VIRGINIA LEIGH
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:LEIGH
Last Name:LUTHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 LAKEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:LITTLE EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08087-1725
Mailing Address - Country:US
Mailing Address - Phone:609-713-8514
Mailing Address - Fax:
Practice Address - Street 1:101 LAKEWOOD CT
Practice Address - Street 2:
Practice Address - City:LITTLE EGG HARBOR TWP
Practice Address - State:NJ
Practice Address - Zip Code:08087-1725
Practice Address - Country:US
Practice Address - Phone:609-713-8514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst