Healthcare Provider Details

I. General information

NPI: 1215496823
Provider Name (Legal Business Name): LISA LYN SCHELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2019
Last Update Date: 03/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4810 OXFORD ST
KENSINGTON MD
20895-1245
US

IV. Provider business mailing address

850 HUNGERFORD DR
ROCKVILLE MD
20850-1718
US

V. Phone/Fax

Practice location:
  • Phone: 240-740-0700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number05914
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: