National Provider Identifier

Lisa Carol Pedersen

Lisa Carol Pedersen is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Webster, NY and a listed phone number of (585) 216-0000.

NPI 1093092512Webster, NYSpeech-Language Pathologist

Profile Overview

NPI
1093092512
Provider Type
Individual
Primary Specialty
Speech-Language Pathologist
Enumeration Date
November 11, 2011
Last Updated
November 11, 2011

Practice Location

  • 119 South Ave
  • Webster, NY 14580-3559

Phone: (585) 216-0000

Mailing Address

  • 132 Bellehurst Dr
  • Rochester, NY 14617-2208

Specialties

  • Speech-Language Pathologist (235Z00000X)
Full Record
NPI
1093092512
Entity Type
Individual
Last Name
Pedersen
First Name
Lisa
Middle Name
Carol
Name Prefix
Mrs.
Mailing Street Address
132 Bellehurst Dr
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14617-2208
Mailing Country
US
Mailing Phone
(585) 654-9332
Practice Street Address
119 South Ave
Practice City
Webster
Practice State
NY
Practice ZIP Code
14580-3559
Practice Country
US
Practice Phone
(585) 216-0000
Enumeration Date
November 11, 2011
Last Updated
November 11, 2011
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Speech-Language Pathologist (235Z00000X)