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NPI Code Detail

MEDICARE: MISS LISA ANN JONES MA CCC-SLP

MEDICARE: MISS LISA ANN JONES MA 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 Pathologist7595OH

General Provider Information

NPI Number : 1780705525
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS LISA ANN JONES MA CCC-SLP
Provider Business Mailing Address
First Line : 11850 EDGEWATER DR APT 820
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-6400
Country : US
Telephone Number : 216-849-2306
Fax Number :
Provider Business Practice Location Address
First Line : 6606 CARNEGIE AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44103-4622
Country : US
Telephone Number : 216-361-1414
Fax Number : 216-426-1383
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2007
Last Update Date : 07/08/2007

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