| Doctor Name: | LISA IZENWASSER |
| NPI Number: | 1871682492 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA CCC-SLP |
| License Number: | SA 5221 |
| Business Practice Address: | 7200 Griffin Rd Suite 3 Davie, FL - 333144144 |
| Business Phone Number: | 9547914460 |
| Business Fax Number: | 9547917670 |
| Mailing Address: | 3990 Lansing Ave, HOLLYWOOD |
| State: | FL |
| Postal Code: | 330264929 |
| Phone Number: | 9543252515 |
| Fax Number: | 4409654303 |
| NPI Enumeration Date: | 10/12/2006 |
| NPI Last Update Date: | 07/27/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SA 5221 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| 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 |