Provider Demographics
NPI:1013111863
Name:SOMMERS, LISA (MA, CCC,SLP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:SOMMERS
Suffix:
Gender:F
Credentials:MA, CCC,SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 N PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01003-9296
Mailing Address - Country:US
Mailing Address - Phone:413-545-4010
Mailing Address - Fax:
Practice Address - Street 1:358 N PLEASANT ST
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01003-9296
Practice Address - Country:US
Practice Address - Phone:413-545-4010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7055235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist