Provider Demographics
NPI:1760673131
Name:LUTZ, AMY (SLP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:LUTZ
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5465 ROUTE 8
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-9696
Mailing Address - Country:US
Mailing Address - Phone:724-444-5333
Mailing Address - Fax:724-444-5335
Practice Address - Street 1:5465 ROUTE 8
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-9696
Practice Address - Country:US
Practice Address - Phone:724-444-5333
Practice Address - Fax:724-444-5335
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL004356L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist