Provider Demographics
NPI:1457104952
Name:HUNTINGTON, LISA CLARE
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:CLARE
Last Name:HUNTINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5159 LOCKWOOD RD
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:OH
Mailing Address - Zip Code:44081-9724
Mailing Address - Country:US
Mailing Address - Phone:440-221-2950
Mailing Address - Fax:
Practice Address - Street 1:5159 LOCKWOOD RD
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:OH
Practice Address - Zip Code:44081-9724
Practice Address - Country:US
Practice Address - Phone:440-221-2950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide