Provider Demographics
NPI:1013549294
Name:OGILVY, LISA J (HIS)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:J
Last Name:OGILVY
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 HIGH RIDGE RD FL 3
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-3813
Mailing Address - Country:US
Mailing Address - Phone:203-348-2271
Mailing Address - Fax:
Practice Address - Street 1:111 HIGH RIDGE RD FL 3
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-3813
Practice Address - Country:US
Practice Address - Phone:203-348-2271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT449237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist