Provider Demographics
NPI:1558548289
Name:LISKA, KATHKEEN
Entity Type:Individual
Prefix:
First Name:KATHKEEN
Middle Name:
Last Name:LISKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3922
Mailing Address - Country:US
Mailing Address - Phone:508-775-6240
Mailing Address - Fax:
Practice Address - Street 1:83 PEARL ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3922
Practice Address - Country:US
Practice Address - Phone:508-775-6240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant