Provider Demographics
NPI:1922258490
Name:KLEIN, LISA R (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:R
Last Name:KLEIN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:BIGMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:151 SUMMIT AVE
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-2813
Mailing Address - Country:US
Mailing Address - Phone:908-598-0228
Mailing Address - Fax:908-598-0175
Practice Address - Street 1:151 SUMMIT AVE
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-2813
Practice Address - Country:US
Practice Address - Phone:908-598-0228
Practice Address - Fax:908-598-0175
Is Sole Proprietor?:No
Enumeration Date:2008-09-22
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00517000235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist