MEDICARE: LISA LORUBBIO

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
1	103TS0200X	School Psychologist

General Provider Information

NPI Number	:	1215334826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA LORUBBIO

Provider Business Mailing Address
First Line	:	1226 E STATE ST
Second Line	:
City	:	SALEM
State	:	OH
Zip	:	44460-2222
Country	:	US
Telephone Number	:	330-332-0316
Fax Number	:	330-332-8936

Provider Business Practice Location Address
First Line	:	1226 E STATE ST
Second Line	:
City	:	SALEM
State	:	OH
Zip	:	44460-2222
Country	:	US
Telephone Number	:	330-332-0316
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/25/2014
Last Update Date	:	11/25/2014

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Directions to “ LISA LORUBBIO ” Practice Location

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