Provider Demographics
NPI:1518389436
Name:LUCKOSKI, CATHRYN (MS, CCC/A)
Entity Type:Individual
Prefix:MS
First Name:CATHRYN
Middle Name:
Last Name:LUCKOSKI
Suffix:
Gender:F
Credentials:MS, CCC/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 WINDING WAY
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-2055
Mailing Address - Country:US
Mailing Address - Phone:317-569-9084
Mailing Address - Fax:
Practice Address - Street 1:330 WINDING WAY
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-2055
Practice Address - Country:US
Practice Address - Phone:317-569-9084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-12
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002253A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist