Provider Demographics
NPI:1891078283
Name:PACE, LISA (BCABA)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:PACE
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3236 LANDMARK DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29418-8488
Mailing Address - Country:US
Mailing Address - Phone:843-608-6598
Mailing Address - Fax:843-608-6598
Practice Address - Street 1:3236 LANDMARK DR
Practice Address - Street 2:SUITE 103
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29418-8488
Practice Address - Country:US
Practice Address - Phone:843-608-6598
Practice Address - Fax:843-608-6598
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst