Provider Demographics
NPI:1477986305
Name:SEITZ, LISA LYNN (SLP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:LYNN
Last Name:SEITZ
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5909 EL DIENTE CT
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80403-2042
Mailing Address - Country:US
Mailing Address - Phone:303-263-4391
Mailing Address - Fax:
Practice Address - Street 1:5909 EL DIENTE CT
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80403-2042
Practice Address - Country:US
Practice Address - Phone:303-263-4391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0000111235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist