Provider Demographics
NPI:1750374211
Name:LIZZUL, LEE ANN (MS, CCC-A)
Entity type:Individual
Prefix:MISS
First Name:LEE
Middle Name:ANN
Last Name:LIZZUL
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5014 EL CAMINO DR STE 200
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-2104
Mailing Address - Country:US
Mailing Address - Phone:719-633-4100
Mailing Address - Fax:719-358-5299
Practice Address - Street 1:5014 EL CAMINO DR STE 200
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-2104
Practice Address - Country:US
Practice Address - Phone:719-633-4100
Practice Address - Fax:719-358-5299
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO90231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
01025654OtherASHA
CO90OtherCO AUDIOLOGY LICENCE