Provider Demographics
NPI:1437334984
Name:PISHNEY, LISA ANN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:PISHNEY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 BEAVER DAM RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-8903
Mailing Address - Country:US
Mailing Address - Phone:919-244-7912
Mailing Address - Fax:919-869-1942
Practice Address - Street 1:1030 BEAVER DAM RD
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-8903
Practice Address - Country:US
Practice Address - Phone:919-244-7912
Practice Address - Fax:919-869-1942
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2992235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7488180Medicaid
NC7210179Medicaid