Provider Demographics
NPI:1700084688
Name:LUICK, ANTHONY H (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:H
Last Name:LUICK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 E RIVER RD
Mailing Address - Street 2:SUITE 125
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-6514
Mailing Address - Country:US
Mailing Address - Phone:520-299-7779
Mailing Address - Fax:520-299-7700
Practice Address - Street 1:2200 E RIVER RD
Practice Address - Street 2:SUITE 125
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-6514
Practice Address - Country:US
Practice Address - Phone:520-299-7779
Practice Address - Fax:520-299-7700
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ748103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist