MEDICARE: CARI LYNN LUKCSO MS CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	7189	OH

General Provider Information

NPI Number	:	1952511636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARI LYNN LUKCSO MS CCC-SLP

Provider Business Mailing Address
First Line	:	3485 NAUTILUS TRL
Second Line	:
City	:	REMINDERVILLE
State	:	OH
Zip	:	44202-9048
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7233 WHIPPLE AVE NW
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-7137
Country	:	US
Telephone Number	:	330-498-8200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	07/08/2007

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