Provider Demographics
NPI:1275978363
Name:GEARY, LISA
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:GEARY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:ZIPIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:104 YORKVIEW RD
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23692-4246
Mailing Address - Country:US
Mailing Address - Phone:443-854-7684
Mailing Address - Fax:
Practice Address - Street 1:105 TERREBONNE RD
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23692-4817
Practice Address - Country:US
Practice Address - Phone:443-854-7684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-03
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03637235Z00000X
VA2202006716235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist