Healthcare Provider Details
I. General information
NPI: 1538711734
Provider Name (Legal Business Name): ISABELLE LEMLY SLP-CF
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/09/2019
Last Update Date: 07/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
685 RIVER AVE
LAKEWOOD NJ
08701-5288
US
IV. Provider business mailing address
312A LITTLE FALLS ST
FALLS CHURCH VA
22046-2634
US
V. Phone/Fax
- Phone: 732-367-3667
- Fax:
- Phone: 206-930-3378
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: