| Doctor Name: | MRS. LISA SUSANNE BAILLARGEON |
| NPI Number: | 1376833376 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CCC-SLP |
| License Number: | SA 10155 |
| Business Practice Address: | 621 E. Woolbright Rd. Apt. B406 Boynton Beach, FL - 33435 |
| Business Phone Number: | 6168864568 |
| Business Fax Number: | |
| Mailing Address: | 520 Butternut Dr. Ste. 8, Pmb #224 HOLLAND |
| State: | MI |
| Postal Code: | 49424 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 04/11/2011 |
| NPI Last Update Date: | 04/11/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SA 10155 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| 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 |