Provider Demographics
NPI:1023345238
Name:HOUBEN, LISA (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:
Last Name:HOUBEN
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 1:7593 MARTINIQUE BLVD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-4932
Mailing Address - Country:US
Mailing Address - Phone:561-392-3697
Mailing Address - Fax:
Practice Address - Street 1:160 NW 4TH ST
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-3826
Practice Address - Country:US
Practice Address - Phone:561-391-8444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA9548235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist