Provider Demographics
NPI:1881148260
Name:LUMINA SPEECH AND HEARING SERVICES
Entity type:Organization
Organization Name:LUMINA SPEECH AND HEARING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/ SLP
Authorized Official - Prefix:MS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MALINSKY-ROCKWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MED CCC-SLP/ CED
Authorized Official - Phone:724-366-1166
Mailing Address - Street 1:79 CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-4210
Mailing Address - Country:US
Mailing Address - Phone:724-366-1166
Mailing Address - Fax:
Practice Address - Street 1:383 DIXON BLVD
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-3967
Practice Address - Country:US
Practice Address - Phone:724-366-1166
Practice Address - Fax:724-322-1072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-15
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL001726R235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01471902OtherHMO
PA1032710370001Medicaid
PA01884401Medicaid