Provider Demographics
NPI:1205155934
Name:STRATTON, LISA JA-NEEN (MA)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:JA-NEEN
Last Name:STRATTON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 PARSONS TER
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-7343
Mailing Address - Country:US
Mailing Address - Phone:727-735-6170
Mailing Address - Fax:
Practice Address - Street 1:607 PARSONS TER
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-7343
Practice Address - Country:US
Practice Address - Phone:727-735-6170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 5436235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist