Doctor Name: | MRS. LISA BLOECHLE |
NPI Number: | 1821385246 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A.,CCC-SLP |
License Number: | 005682 |
Business Practice Address: | 301 Smithtown Blvd Nesconset, NY - 117672080 |
Business Phone Number: | 6315880530 |
Business Fax Number: | |
Mailing Address: | 261 6th Ave, SAINT JAMES |
State: | NY |
Postal Code: | 117802707 |
Phone Number: | 6318621739 |
Fax Number: | |
NPI Enumeration Date: | 07/06/2011 |
NPI Last Update Date: | 07/06/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 005682 |
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 |