Provider Demographics
NPI:1881924306
Name:LUEKEN, ANDREA SUE (OTR/L)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:SUE
Last Name:LUEKEN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3701 WAKE FOREST RD
Mailing Address - Street 2:STE 100
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-6832
Mailing Address - Country:US
Mailing Address - Phone:919-872-3171
Mailing Address - Fax:919-872-6739
Practice Address - Street 1:3701 WAKE FOREST RD
Practice Address - Street 2:STE 100
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6832
Practice Address - Country:US
Practice Address - Phone:919-872-3171
Practice Address - Fax:919-872-6739
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-06
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7724225X00000X, 225XP0019X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation