Doctor Name: | LISA SHOEMAKER |
NPI Number: | 1679740666 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 4258 |
Business Practice Address: | 4950 Mcnutt Rd Santa Teresa, NM - 880089621 |
Business Phone Number: | 5758826200 |
Business Fax Number: | |
Mailing Address: | 4950 Mcnutt Rd, SANTA TERESA |
State: | NM |
Postal Code: | 880089621 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/09/2008 |
NPI Last Update Date: | 05/09/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 4258 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
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 |