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NPI Code Detail

MEDICARE: LISA S MCNIFF

MEDICARE: LISA S MCNIFF
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
1235Z00000XSpeech-Language Pathologist118073MO

General Provider Information

NPI Number : 1245370329
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA S MCNIFF
Provider Business Mailing Address
First Line : 3086 ABERDEEN DR
Second Line :
City : FLORISSANT
State : MO
Zip : 63033-1504
Country : US
Telephone Number : 314-852-1508
Fax Number :
Provider Business Practice Location Address
First Line : 56 WORTHINGTON ACCESS DR
Second Line :
City : MARYLAND HEIGHTS
State : MO
Zip : 63043-3806
Country : US
Telephone Number : 314-439-0800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2007
Last Update Date : 07/08/2007

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Directions to “ LISA S MCNIFF ” Practice Location

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