Doctor Name: | MS. LISA KAREN FENTER |
NPI Number: | 1497025779 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLPCCC |
License Number: | 012034 |
Business Practice Address: | 150 Abbey Ln Levittown, NY - 117564042 |
Business Phone Number: | 5165208300 |
Business Fax Number: | |
Mailing Address: | 1794 Beech St, WANTAGH |
State: | NY |
Postal Code: | 117933430 |
Phone Number: | 5167837270 |
Fax Number: | |
NPI Enumeration Date: | 01/04/2012 |
NPI Last Update Date: | 01/04/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 012034 |
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 |