Provider Demographics
NPI:1467892901
Name:GALLIHER, LISA K (BC-HIS)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:K
Last Name:GALLIHER
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:K
Other - Last Name:MANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5427 W MCNEIL ST
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-9769
Mailing Address - Country:US
Mailing Address - Phone:623-332-7349
Mailing Address - Fax:
Practice Address - Street 1:5427 W MCNEIL ST
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-9769
Practice Address - Country:US
Practice Address - Phone:623-332-7349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-28
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4446237600000X, 237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty