Provider Demographics
NPI:1114072089
Name:LUTHER, ERIKA LEA
Entity Type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:LEA
Last Name:LUTHER
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ERIKA
Other - Middle Name:LEA
Other - Last Name:WAGNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13737 MEADOWBROOK CT
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-6165
Mailing Address - Country:US
Mailing Address - Phone:303-588-2833
Mailing Address - Fax:
Practice Address - Street 1:13737 MEADOWBROOK CT
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-6165
Practice Address - Country:US
Practice Address - Phone:303-588-2833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0207313231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO82925216Medicaid