Provider Demographics
NPI:1245361997
Name:LUSHKO, WENDY JO (MSCCCSLP)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:JO
Last Name:LUSHKO
Suffix:
Gender:F
Credentials:MSCCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 JONQUIL PL
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15228-2512
Mailing Address - Country:US
Mailing Address - Phone:412-561-1447
Mailing Address - Fax:
Practice Address - Street 1:1401 HAMILTON RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15234-2364
Practice Address - Country:US
Practice Address - Phone:412-884-4262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL006417L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist