Provider Demographics
NPI:1831685312
Name:NAUMANN, LIZA MARIE
Entity type:Individual
Prefix:
First Name:LIZA
Middle Name:MARIE
Last Name:NAUMANN
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 1:55 ROLLING ACRES DR
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-2613
Mailing Address - Country:US
Mailing Address - Phone:401-263-1382
Mailing Address - Fax:
Practice Address - Street 1:20 AUSTIN AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:RI
Practice Address - Zip Code:02828-1449
Practice Address - Country:US
Practice Address - Phone:401-949-3880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-08
Last Update Date:2018-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RISP00561235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist