Provider Demographics
NPI:1689635476
Name:SCHAUPP, LISA A (MA,CCC-A)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:A
Last Name:SCHAUPP
Suffix:
Gender:F
Credentials:MA,CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4524 RUXTON RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43612-2240
Mailing Address - Country:US
Mailing Address - Phone:419-882-2827
Mailing Address - Fax:
Practice Address - Street 1:4524 RUXTON RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43612-2240
Practice Address - Country:US
Practice Address - Phone:419-882-2827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA00561231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0701362Medicare PIN