Individual
MRS. GINA MARIE LUTYENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
1201 N 15TH ST, CLARKSBURG, WV 26301-1989
(304) 624-6554
(304) 624-5223
Mailing address
PO BOX 1370, CLARKSBURG, WV 26302-1370
(304) 624-6554
(304) 624-5223
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
G7U136500017
WV
Other
Enumeration date
10/03/2013
Last updated
10/03/2013
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