MEDICARE: LISA A SCHAUPP M.A.,CCC-A

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	231H00000X	Audiologist	A00561	OH

General Provider Information

NPI Number	:	1689635476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA A SCHAUPP M.A.,CCC-A

Provider Business Mailing Address
First Line	:	4524 RUXTON RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43612-2240
Country	:	US
Telephone Number	:	419-882-2827
Fax Number	:

Provider Business Practice Location Address
First Line	:	4524 RUXTON RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43612-2240
Country	:	US
Telephone Number	:	419-882-2827
Fax Number	:

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

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	03/19/2019

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