| Doctor Name: | LISA A WEISEDEL |
| NPI Number: | 1295862498 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP |
| License Number: | 013104 |
| Business Practice Address: | 10714 North Rd Perrysburg, NY - 141299746 |
| Business Phone Number: | 7165321049 |
| Business Fax Number: | 7165320679 |
| Mailing Address: | 2168 Woode Ave, NORTH COLLINS |
| State: | NY |
| Postal Code: | 141119408 |
| Phone Number: | 7163370390 |
| Fax Number: | |
| NPI Enumeration Date: | 02/27/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 013104 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |