Provider Demographics
NPI:1063826345
Name:OSLIN, LISA ROXANNE (AUD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ROXANNE
Last Name:OSLIN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 COLEMANS XING STE 200
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-7080
Mailing Address - Country:US
Mailing Address - Phone:937-578-2207
Mailing Address - Fax:
Practice Address - Street 1:140 COLEMANS XING STE 200
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-7080
Practice Address - Country:US
Practice Address - Phone:937-578-2207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-16
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH01898231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist