Provider Demographics
NPI:1811018179
Name:SNELL, LISA M
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:SNELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 FALLING LEAVES DR
Mailing Address - Street 2:
Mailing Address - City:ADKINS
Mailing Address - State:TX
Mailing Address - Zip Code:78101-2624
Mailing Address - Country:US
Mailing Address - Phone:830-460-1484
Mailing Address - Fax:830-393-8294
Practice Address - Street 1:727 FALLING LEAVES DR
Practice Address - Street 2:
Practice Address - City:ADKINS
Practice Address - State:TX
Practice Address - Zip Code:78101-2624
Practice Address - Country:US
Practice Address - Phone:830-460-1484
Practice Address - Fax:830-393-8294
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80231237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist