Doctor Name: | LISA SAMORE |
NPI Number: | 1366887838 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | SP19623 |
Business Practice Address: | 16500 Ventura Blvd Ste. 414 Encino, CA - 914362011 |
Business Phone Number: | 8187881003 |
Business Fax Number: | 8187881135 |
Mailing Address: | 16500 Ventura Blvd, Ste. 414 ENCINO |
State: | CA |
Postal Code: | 914362011 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/09/2013 |
NPI Last Update Date: | 05/09/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP19623 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
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 |