Provider Demographics
NPI:1609424209
Name:TUIT, LISA JOAN (MA CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:JOAN
Last Name:TUIT
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4109 WOODBERRY ST
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20782-1170
Mailing Address - Country:US
Mailing Address - Phone:301-864-0653
Mailing Address - Fax:
Practice Address - Street 1:4109 WOODBERRY ST
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PARK
Practice Address - State:MD
Practice Address - Zip Code:20782-1170
Practice Address - Country:US
Practice Address - Phone:301-864-0653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-28
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07390235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD07390OtherBOARD OF AUDIOLOGISTS, HEARING AID DISPENSERS & SPEECH-LANGUAGE PATHOLOGISTS