Provider Demographics
NPI:1942612957
Name:CRANE, LISA EDWARDS (MA ED)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:EDWARDS
Last Name:CRANE
Suffix:
Gender:F
Credentials:MA ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:854 4TH AVE W APT 1
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-4828
Mailing Address - Country:US
Mailing Address - Phone:828-782-0286
Mailing Address - Fax:
Practice Address - Street 1:854 4TH AVE W APT 1
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4828
Practice Address - Country:US
Practice Address - Phone:828-782-0286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-24
Last Update Date:2014-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1859235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist