Provider Demographics
NPI:1396931887
Name:DOWNEY, LISA MARIE (MS CCC-SLP/L)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:MARIE
Last Name:DOWNEY
Suffix:
Gender:F
Credentials:MS CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14982 CANTOR CHASE CROSSING
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46040
Mailing Address - Country:US
Mailing Address - Phone:773-405-9614
Mailing Address - Fax:
Practice Address - Street 1:14982 CANTOR CHASE CROSSING
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46040
Practice Address - Country:US
Practice Address - Phone:773-405-9614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.007679235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist