Provider Demographics
NPI:1558553826
Name:WESTBROOK, LISA R (MED, CCC-A)
Entity Type:Individual
Prefix:MR
First Name:LISA
Middle Name:R
Last Name:WESTBROOK
Suffix:
Gender:F
Credentials:MED, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 LUCY DR
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-8050
Mailing Address - Country:US
Mailing Address - Phone:540-434-3977
Mailing Address - Fax:
Practice Address - Street 1:3031 VALLEY AVE
Practice Address - Street 2:SUITE 105A
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2656
Practice Address - Country:US
Practice Address - Phone:540-434-3977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001094237600000X
VA2101001313237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter