Provider Demographics
NPI:1093723116
Name:DUNWOODY, LISA BONO (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:BONO
Last Name:DUNWOODY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14031 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 610
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3575
Mailing Address - Country:US
Mailing Address - Phone:281-494-0606
Mailing Address - Fax:
Practice Address - Street 1:14031 SOUTHWEST FWY
Practice Address - Street 2:SUITE 610
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3575
Practice Address - Country:US
Practice Address - Phone:281-494-0606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19041235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist