Provider Demographics
NPI:1932212875
Name:CALLNER, LISA BETH (MA,CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:BETH
Last Name:CALLNER
Suffix:
Gender:F
Credentials:MA,CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1234 BAY AREA BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2538
Mailing Address - Country:US
Mailing Address - Phone:281-488-7221
Mailing Address - Fax:281-488-2103
Practice Address - Street 1:1234 BAY AREA BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2538
Practice Address - Country:US
Practice Address - Phone:281-488-7221
Practice Address - Fax:281-488-2103
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10286235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist