Doctor Name: | MS. MARY LISA LACHES |
NPI Number: | 1942338181 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | SA 4467 |
Business Practice Address: | 2125 Harden Blvd Lakeland, FL - 338035918 |
Business Phone Number: | 8636871189 |
Business Fax Number: | |
Mailing Address: | 18012 Forest Retreat Ln, TAMPA |
State: | FL |
Postal Code: | 336473165 |
Phone Number: | 8139070284 |
Fax Number: | |
NPI Enumeration Date: | 03/01/2007 |
NPI Last Update Date: | 02/04/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA 4467 |
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 |