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NPI Code Detail

MEDICARE: EMERSON LISE GAGNON

MEDICARE: EMERSON LISE GAGNON
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 PathologistPA

General Provider Information

NPI Number : 1285578971
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMERSON LISE GAGNON
Provider Business Mailing Address
First Line : 57 CHELTENHAM DR
Second Line :
City : WYOMISSING
State : PA
Zip : 19610-1840
Country : US
Telephone Number : 443-918-5575
Fax Number :
Provider Business Practice Location Address
First Line : 115 SUDBROOK LN STE A
Second Line :
City : PIKESVILLE
State : MD
Zip : 21208-4184
Country : US
Telephone Number : 443-918-5575
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2026
Last Update Date : 04/20/2026

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Directions to “ EMERSON LISE GAGNON ” Practice Location

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