Provider Demographics
NPI:1558718536
Name:ERWIN, LISA
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:ERWIN
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 1:3440 BELL ST
Mailing Address - Street 2:SUITE 306
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-4142
Mailing Address - Country:US
Mailing Address - Phone:806-331-6084
Mailing Address - Fax:806-331-6085
Practice Address - Street 1:3440 BELL ST
Practice Address - Street 2:SUITE 306
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-4142
Practice Address - Country:US
Practice Address - Phone:806-331-6084
Practice Address - Fax:806-331-6085
Is Sole Proprietor?:No
Enumeration Date:2016-05-19
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist