Doctor Name: | MRS. MARY ANN LYSAGHT |
NPI Number: | 1467614107 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | |
Business Practice Address: | 1040 S Winter St Ste 1022 Adrian, MI - 492213876 |
Business Phone Number: | 5172638905 |
Business Fax Number: | 5172658237 |
Mailing Address: | 1040 S Winter St Ste 1022, ADRIAN |
State: | MI |
Postal Code: | 492213876 |
Phone Number: | 5172638905 |
Fax Number: | 5172658237 |
NPI Enumeration Date: | 06/25/2008 |
NPI Last Update Date: | 06/25/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
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 |