Provider Demographics
NPI:1629307186
Name:LUFF, ANITA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:
Last Name:LUFF
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 BARN DANCE WAY
Mailing Address - Street 2:
Mailing Address - City:OAKLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94561-1766
Mailing Address - Country:US
Mailing Address - Phone:925-437-3744
Mailing Address - Fax:925-679-2925
Practice Address - Street 1:4501 SAND CREEK RD
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-8687
Practice Address - Country:US
Practice Address - Phone:925-813-3560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-12
Last Update Date:2009-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP13834235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist