Provider Demographics
NPI:1336455484
Name:DOWNEY, LISA CHAPMAN (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:CHAPMAN
Last Name:DOWNEY
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 1:14 CRESTWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04021-4049
Mailing Address - Country:US
Mailing Address - Phone:207-829-5656
Mailing Address - Fax:
Practice Address - Street 1:196 ALLEN AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-3711
Practice Address - Country:US
Practice Address - Phone:207-874-8133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP753235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist