Provider Demographics
NPI:1821738964
Name:SPEIR, LISA RITTER (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:RITTER
Last Name:SPEIR
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 POINTER DR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:GA
Mailing Address - Zip Code:31763-5895
Mailing Address - Country:US
Mailing Address - Phone:229-854-8762
Mailing Address - Fax:
Practice Address - Street 1:214 POINTER DR
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:GA
Practice Address - Zip Code:31763-5895
Practice Address - Country:US
Practice Address - Phone:229-854-8762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP003413235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist