Provider Demographics
NPI:1235689704
Name:LUIKENS, BRITTNI
Entity Type:Individual
Prefix:
First Name:BRITTNI
Middle Name:
Last Name:LUIKENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14617 TELLURIDE ST
Mailing Address - Street 2:
Mailing Address - City:SUMMERSET
Mailing Address - State:SD
Mailing Address - Zip Code:57769-6205
Mailing Address - Country:US
Mailing Address - Phone:605-390-4294
Mailing Address - Fax:
Practice Address - Street 1:14617 TELLURIDE ST
Practice Address - Street 2:
Practice Address - City:SUMMERSET
Practice Address - State:SD
Practice Address - Zip Code:57769-6205
Practice Address - Country:US
Practice Address - Phone:605-390-4294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-09
Last Update Date:2016-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD536235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist