Provider Demographics
NPI:1740300169
Name:PAYNE, LISA (MA, CCC-A)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:PAYNE
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 YORK RD
Mailing Address - Street 2:TOWSON UNIVERSITY SPEECH LANGUAGE HEARING CTR
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21252-0001
Mailing Address - Country:US
Mailing Address - Phone:410-704-3095
Mailing Address - Fax:410-704-6303
Practice Address - Street 1:8000 YORK RD
Practice Address - Street 2:TOWSON UNIVERSITY SPEECH LANGUAGE HEARING CTR
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21252-0001
Practice Address - Country:US
Practice Address - Phone:410-704-3095
Practice Address - Fax:410-704-6303
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01090231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist