Most Relevant Information
Provider Data
| NPI Number: | 1003260126 |
| Provider Name: | LISA LUSSETTO |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 1717 |
Most Important Dates
| Enumeration Date: | 04/14/2016 |
| Last Updated: | 04/14/2016 |
Provider Practice Location
800 Q ST
BRIDGEPORT
NE
693362519
Practice Location Phone/Fax
| Phone: | 3082621574 |
| Fax: |
Provider Mailing Location
PO BOX 430
BRIDGEPORT
NE
693360430
Provider Mailing Phone/Fax
| Phone: | 3082621574 |
| Fax: |