MEDICARE: LISA DAYTON 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
1	235Z00000X	Speech-Language Pathologist	017382-1	NY
2	235Z00000X	Speech-Language Pathologist		VT

General Provider Information

NPI Number	:	1831397769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA DAYTON SLP

Provider Business Mailing Address
First Line	:	2321 MIDDLE RD
Second Line	:
City	:	NORTH CLARENDON
State	:	VT
Zip	:	05759-9501
Country	:	US
Telephone Number	:	802-775-3264
Fax Number	:

Provider Business Practice Location Address
First Line	:	2321 MIDDLE RD STE 1
Second Line	:
City	:	NORTH CLARENDON
State	:	VT
Zip	:	05759-9501
Country	:	US
Telephone Number	:	802-775-3264
Fax Number	:

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

Provider Enumeration Date	:	07/03/2007
Last Update Date	:	08/17/2021

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Directions to “ LISA DAYTON SLP” Practice Location

Language	Start Address	Practice Location

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