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NPI Code Detail

MEDICARE: DR. LISA SCHOENBRODT EDD CCC SLP

MEDICARE: DR. LISA SCHOENBRODT EDD CCC SLP
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 Pathologist01493MD

General Provider Information

NPI Number : 1710017033
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LISA SCHOENBRODT EDD CCC SLP
Provider Business Mailing Address
First Line : 3702 LIGON ROAD
Second Line :
City : ELLICOTT CITY
State : MO
Zip : 21042
Country : US
Telephone Number : 410-241-0874
Fax Number : 410-418-4776
Provider Business Practice Location Address
First Line : 10910 CLARKSVILLE PIKE
Second Line :
City : ELLICOTT CITY
State : MD
Zip : 21042-6106
Country : US
Telephone Number : 410-313-6600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2007
Last Update Date : 11/13/2018

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