Provider Demographics
NPI:1720272883
Name:DUNSTON-HOWARD, LISA SHANTELL (SLPA)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:SHANTELL
Last Name:DUNSTON-HOWARD
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:SHANTELL
Other - Last Name:DUNSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 97051
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27624-7051
Mailing Address - Country:US
Mailing Address - Phone:919-478-9974
Mailing Address - Fax:888-354-2009
Practice Address - Street 1:10704 DEBMOOR PL STE 200
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-7018
Practice Address - Country:US
Practice Address - Phone:919-478-9974
Practice Address - Fax:888-354-2009
Is Sole Proprietor?:No
Enumeration Date:2007-08-31
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01442355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant