Individual
MRS. LAURIE ANN LUSTIBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SP
Contact information
Practice address
182 MEADOWS END RD, MONROE, CT 06468-1741
(203) 261-6582
(203) 268-1084
Mailing address
182 MEADOWS END RD, MONROE, CT 06468-1741
(203) 261-6582
(203) 268-1084
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
001987
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
660001987CT01
ANTHEM BC-BS
CT
Enumeration date
01/10/2007
Last updated
07/08/2007
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