Provider Demographics
NPI:1356796338
Name:FILION, LISA BLEVIS (MS)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:BLEVIS
Last Name:FILION
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PAR PL APT D
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-5889
Mailing Address - Country:US
Mailing Address - Phone:518-744-5107
Mailing Address - Fax:
Practice Address - Street 1:3 PAR PL APT D
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-5889
Practice Address - Country:US
Practice Address - Phone:518-744-5107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-27
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006262235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist