Provider Demographics
NPI:1346317401
Name:KURAK, LISA MARIE (AUD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:MARIE
Last Name:KURAK
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MS
Other - First Name:LISA
Other - Middle Name:MARIE
Other - Last Name:VICTOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:721 TRIXIS PL
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89144-4525
Mailing Address - Country:US
Mailing Address - Phone:702-341-0493
Mailing Address - Fax:
Practice Address - Street 1:2600 S RAINBOW BLVD
Practice Address - Street 2:SUITE #105
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-4006
Practice Address - Country:US
Practice Address - Phone:702-362-3138
Practice Address - Fax:702-362-9983
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA-131231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist