Provider Demographics
NPI:1609277466
Name:LUCHT, SANDRA (BC-HIS)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:LUCHT
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-2965
Mailing Address - Country:US
Mailing Address - Phone:570-622-0590
Mailing Address - Fax:570-622-0370
Practice Address - Street 1:212 W MARKET ST
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-2965
Practice Address - Country:US
Practice Address - Phone:570-622-0590
Practice Address - Fax:570-622-0370
Is Sole Proprietor?:No
Enumeration Date:2014-09-11
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2735237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist