MEDICARE: MR. LOWELL ORRIN LUECK LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MFC30424	CA

General Provider Information

NPI Number	:	1215198890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LOWELL ORRIN LUECK LMFT

Provider Business Mailing Address
First Line	:	5401 BUSINESS PARK SOUTH
Second Line	:	100
City	:	BAKERSFIELD
State	:	CA
Zip	:	93309-0721
Country	:	US
Telephone Number	:	661-205-5018
Fax Number	:	661-589-2143

Provider Business Practice Location Address
First Line	:	5401 BUSINESS PARK S
Second Line	:	100
City	:	BAKERSFIELD
State	:	CA
Zip	:	93309-0721
Country	:	US
Telephone Number	:	661-205-5018
Fax Number	:	661-589-2143

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2008
Last Update Date	:	06/17/2008

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