Provider Demographics
NPI:1720381288
Name:BRITTINGHAM, LISA W (MA CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:W
Last Name:BRITTINGHAM
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 1:113 CONOY ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1608
Mailing Address - Country:US
Mailing Address - Phone:717-234-5662
Mailing Address - Fax:
Practice Address - Street 1:113 CONOY ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104-1608
Practice Address - Country:US
Practice Address - Phone:717-234-5662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL001912L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist