Doctor Name: | LISA BELLAVIA |
NPI Number: | 1508235854 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | |
Business Practice Address: | 5341 Highway 17 Murrells Inlet, SC - 295765074 |
Business Phone Number: | 8438552333 |
Business Fax Number: | 8439035541 |
Mailing Address: | Po Box 3045, MYRTLE BEACH |
State: | SC |
Postal Code: | 295783045 |
Phone Number: | 8438552333 |
Fax Number: | 8439035541 |
NPI Enumeration Date: | 09/16/2015 |
NPI Last Update Date: | 11/16/2015 |
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 |