Provider Demographics
NPI:1053609370
Name:LUEKENGA, JOSHUA C (AUD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:C
Last Name:LUEKENGA
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 E 3900 S STE 106C
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-1389
Mailing Address - Country:US
Mailing Address - Phone:801-268-3277
Mailing Address - Fax:801-268-3288
Practice Address - Street 1:1255 E 3900 S STE 106C
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-1389
Practice Address - Country:US
Practice Address - Phone:801-268-3277
Practice Address - Fax:801-268-3288
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8029647-4101231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist