Provider Demographics
NPI:1346571247
Name:MASON, LUANE C (MA)
Entity Type:Individual
Prefix:MRS
First Name:LUANE
Middle Name:C
Last Name:MASON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 JUANITA CT
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-6619
Mailing Address - Country:US
Mailing Address - Phone:727-535-3424
Mailing Address - Fax:727-216-3573
Practice Address - Street 1:1811 JUANITA CT
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-6619
Practice Address - Country:US
Practice Address - Phone:727-535-3424
Practice Address - Fax:727-216-3573
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-18
Last Update Date:2010-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA674235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist