Provider Demographics
NPI:1043357353
Name:CURNUTT, LUCRETIA (SLP)
Entity Type:Individual
Prefix:
First Name:LUCRETIA
Middle Name:
Last Name:CURNUTT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:LUCRETIA
Other - Middle Name:
Other - Last Name:WILKINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:20229 ARROLL ROAD
Mailing Address - Street 2:
Mailing Address - City:WILLOW SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:65793
Mailing Address - Country:US
Mailing Address - Phone:314-302-1335
Mailing Address - Fax:636-733-3332
Practice Address - Street 1:SPECIAL SCHOOL DISTRICT OF ST LOUIS COUNTY
Practice Address - Street 2:12110 CLAYTON RD
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131
Practice Address - Country:US
Practice Address - Phone:314-302-1335
Practice Address - Fax:636-733-3332
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01781235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO463108712Medicaid