Provider Demographics
NPI:1184854887
Name:KUSTES, LIANNE (SLP)
Entity Type:Individual
Prefix:
First Name:LIANNE
Middle Name:
Last Name:KUSTES
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:LIANNE
Other - Middle Name:
Other - Last Name:WEIHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3801 THERINA WAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-1539
Mailing Address - Country:US
Mailing Address - Phone:502-640-6243
Mailing Address - Fax:
Practice Address - Street 1:3801 THERINA WAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-1539
Practice Address - Country:US
Practice Address - Phone:502-640-6243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-16
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3808235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist