Provider Demographics
NPI:1235623513
Name:BROWNING, LISA NICHOLE (SLP, MCD, CCC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:NICHOLE
Last Name:BROWNING
Suffix:
Gender:F
Credentials:SLP, MCD, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 KELLIE LN
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-5751
Mailing Address - Country:US
Mailing Address - Phone:541-228-0050
Mailing Address - Fax:
Practice Address - Street 1:2111 W POINT RD
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:GA
Practice Address - Zip Code:30240-4047
Practice Address - Country:US
Practice Address - Phone:706-812-9293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP007997235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist