Provider Demographics
NPI:1235196908
Name:BUTLER, LISA (MA CCC-A)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:MA CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5520 COLLEGE BLVD
Mailing Address - Street 2:SUITE 370
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1630
Mailing Address - Country:US
Mailing Address - Phone:913-696-8844
Mailing Address - Fax:913-696-8855
Practice Address - Street 1:5520 COLLEGE BLVD
Practice Address - Street 2:SUITE 370
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1630
Practice Address - Country:US
Practice Address - Phone:913-696-8844
Practice Address - Fax:913-696-8855
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1966231H00000X
MO113697231H00000X
KS0158237600000X
MO001239237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter