Provider Demographics
NPI:1205287265
Name:LIANNE KUSTES LLC
Entity type:Organization
Organization Name:LIANNE KUSTES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIANNE
Authorized Official - Middle Name:MARIE WEIHE
Authorized Official - Last Name:KUSTES
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:502-640-6243
Mailing Address - Street 1:3801 THERINA WAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-1539
Mailing Address - Country:US
Mailing Address - Phone:502-640-6243
Mailing Address - Fax:
Practice Address - Street 1:3801 THERINA WAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-1539
Practice Address - Country:US
Practice Address - Phone:502-640-6243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency