Provider Demographics
NPI:1831236595
Name:LUSE, GINGER G (MCD,SLP-CCC)
Entity type:Individual
Prefix:MS
First Name:GINGER
Middle Name:G
Last Name:LUSE
Suffix:
Gender:F
Credentials:MCD,SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 2 BOX 2126
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN
Mailing Address - State:MO
Mailing Address - Zip Code:63965-9603
Mailing Address - Country:US
Mailing Address - Phone:573-300-5811
Mailing Address - Fax:
Practice Address - Street 1:284 MERCHANT ST
Practice Address - Street 2:
Practice Address - City:SAINTE GENEVIEVE
Practice Address - State:MO
Practice Address - Zip Code:63670-1610
Practice Address - Country:US
Practice Address - Phone:573-883-8181
Practice Address - Fax:573-883-8182
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO118330235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist