Provider Demographics
NPI:1356584130
Name:CLOHERTY, LISA COURTNEY (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:COURTNEY
Last Name:CLOHERTY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 WHITAKER LN
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-1617
Mailing Address - Country:US
Mailing Address - Phone:516-456-4154
Mailing Address - Fax:
Practice Address - Street 1:223 CHIEF JUSTICE CUSHING HWY
Practice Address - Street 2:SUITE 201
Practice Address - City:COHASSET
Practice Address - State:MA
Practice Address - Zip Code:02025-1391
Practice Address - Country:US
Practice Address - Phone:781-520-0218
Practice Address - Fax:781-930-1791
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-09
Last Update Date:2013-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7757235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist