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General NPI Number Information
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NPI Number | 1316138555
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Entity Type | Individual
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Provider Name | LISA MARIE BERCH MA, CCC-A
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Gender | Female
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 12/22/2009
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Provider Practice Location Address
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Address Line | 23895 NOVI ROAD SUITE #100
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City | NOVI
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State | MI
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Zip | 48375
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Country | US
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Telephone | 248-348-4327
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Fax | 248-348-4327
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Provider Business Mailing Address
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Address Line | 23895 NOVI ROAD SUITE #100
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City | NOVI
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State | MI
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Zip | 48375
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Country | US
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Telephone | 248-348-4327
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Fax | 248-348-6464
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 1601000085
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License Number State | MI
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