Provider Demographics
NPI:1679796825
Name:LENKNER, LUCRETIA ANN (MS)
Entity type:Individual
Prefix:MS
First Name:LUCRETIA
Middle Name:ANN
Last Name:LENKNER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MUNHALL
Mailing Address - State:PA
Mailing Address - Zip Code:15120-3256
Mailing Address - Country:US
Mailing Address - Phone:412-461-7962
Mailing Address - Fax:412-461-4804
Practice Address - Street 1:4000 MAIN ST
Practice Address - Street 2:
Practice Address - City:MUNHALL
Practice Address - State:PA
Practice Address - Zip Code:15120-3256
Practice Address - Country:US
Practice Address - Phone:412-461-7962
Practice Address - Fax:412-461-4804
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL000116L235Z00000X
PAAT000511L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014182900002Medicaid
PA222348Medicare ID - Type Unspecified
PA0014182900002Medicaid