Individual
LISA LUSSETTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 Q ST, BRIDGEPORT, NE 69336-2519
(308) 262-1574
Mailing address
PO BOX 430, BRIDGEPORT, NE 69336-0430
(308) 262-1574
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1717
NE
Other
Enumeration date
04/14/2016
Last updated
04/14/2016
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