Provider Demographics
NPI:1063710416
Name:LUBKOWSKI, CATHY ANN (MS-SLP/CCC)
Entity type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:ANN
Last Name:LUBKOWSKI
Suffix:
Gender:F
Credentials:MS-SLP/CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7625 ELLICOTT RD
Mailing Address - Street 2:
Mailing Address - City:WEST FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14170-9739
Mailing Address - Country:US
Mailing Address - Phone:716-662-5775
Mailing Address - Fax:
Practice Address - Street 1:355 HARLEM RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-1825
Practice Address - Country:US
Practice Address - Phone:716-821-7023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005329235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01043429OtherA MERICAN SPEECH HEARING ASSOCIATION (ASHA)
NY005329OtherEDUCATION DEPARTMENT OFFICE OF PROFESSIONS