Healthcare Provider Details

I. General information

NPI: 1285394304
Provider Name (Legal Business Name): LILLIAN DANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2021
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109-15 INNOVATION BLVD
SASKATOON SASKATCHEWAN
S7N 2X8
CA

IV. Provider business mailing address

109-15 INNOVATION BLVD
SASKATOON SASKATCHEWAN
S7N 2X8
CA

V. Phone/Fax

Practice location:
  • Phone:
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number40754
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number124535
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2202012112
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: