Provider Demographics
NPI:1518156876
Name:JAKAB, LISA M (AUD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:JAKAB
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6707 POWERS BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-5455
Mailing Address - Country:US
Mailing Address - Phone:440-842-4800
Mailing Address - Fax:440-842-4883
Practice Address - Street 1:6707 POWERS BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5455
Practice Address - Country:US
Practice Address - Phone:440-842-4800
Practice Address - Fax:440-842-4883
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA01619237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter