Provider Demographics
NPI:1770202129
Name:FRISQUE, LIZA
Entity type:Individual
Prefix:
First Name:LIZA
Middle Name:
Last Name:FRISQUE
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 1:319 S CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-7029
Mailing Address - Country:US
Mailing Address - Phone:509-209-7429
Mailing Address - Fax:509-340-9942
Practice Address - Street 1:319 S CEDAR ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-7029
Practice Address - Country:US
Practice Address - Phone:509-209-7429
Practice Address - Fax:509-340-9942
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL61190379235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist