Provider Demographics
NPI:1679621924
Name:MCDONALD, LISA GRACE (MA)
Entity Type:Individual
Prefix:MISS
First Name:LISA
Middle Name:GRACE
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:MA
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Mailing Address - Street 1:524 HIGHLAND AVENUE, 300 FERGUSON AVENUE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27412-5018
Mailing Address - Country:US
Mailing Address - Phone:336-334-5939
Mailing Address - Fax:336-334-4475
Practice Address - Street 1:300 FERGUSON BUILDING
Practice Address - Street 2:UNIVERSITY OF NORTH CAROLINA AT GREENSBORO
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27402-6170
Practice Address - Country:US
Practice Address - Phone:336-256-1142
Practice Address - Fax:336-334-4475
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2020-11-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC4956235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist