Doctor Name: | MRS. LISA W BYWATER |
NPI Number: | 1912045402 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | 03378709 |
Business Practice Address: | 139 N Main St West Hartford, CT - 061071264 |
Business Phone Number: | 8605702399 |
Business Fax Number: | |
Mailing Address: | 108 Whitman Ave, WEST HARTFORD |
State: | CT |
Postal Code: | 061071754 |
Phone Number: | 8605212646 |
Fax Number: | |
NPI Enumeration Date: | 02/05/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 03378709 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
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 |