Provider Demographics
NPI:1356494017
Name:FEIBUS, LISAKAY DRAUGHN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LISAKAY
Middle Name:DRAUGHN
Last Name:FEIBUS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MS
Other - First Name:LISA
Other - Middle Name:KAY
Other - Last Name:DRAUGHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:PO BOX 19964
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30325-0964
Mailing Address - Country:US
Mailing Address - Phone:404-227-1724
Mailing Address - Fax:404-350-5902
Practice Address - Street 1:2126 MAULDIN ST NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-1959
Practice Address - Country:US
Practice Address - Phone:404-227-1724
Practice Address - Fax:404-350-5902
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP003713235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist