Provider Demographics
NPI:1629795836
Name:FENSTER, LISA ADAMS
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ADAMS
Last Name:FENSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:IRENE
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:46 PARK AVE N
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-3113
Mailing Address - Country:US
Mailing Address - Phone:918-640-5589
Mailing Address - Fax:
Practice Address - Street 1:46 PARK AVE N
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-3113
Practice Address - Country:US
Practice Address - Phone:918-640-5589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-27
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15415235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist