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NPI Code Detail

MEDICARE: MRS. LISA R ROCCO CCC, SLP

MEDICARE: MRS. LISA R ROCCO CCC, SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSL003346LPA

General Provider Information

NPI Number : 1003118134
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LISA R ROCCO CCC, SLP
Provider Business Mailing Address
First Line : 517 DUBLIN DR
Second Line :
City : DOWNINGTOWN
State : PA
Zip : 19335-4447
Country : US
Telephone Number : 610-524-0973
Fax Number : 610-524-0973
Provider Business Practice Location Address
First Line : 615 EAST BOOT RD
Second Line : BELLINGHAM RETIREMENT COMMUNITY
City : WEST CHESTER
State : PA
Zip : 19380-0000
Country : US
Telephone Number : 484-653-4426
Fax Number : 610-692-4630
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2010
Last Update Date : 11/22/2010

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