National Provider Identifier

Lisa R. Johnson, CCC-SLP

Lisa R. Johnson, CCC-SLP is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Canandaigua, NY and a listed phone number of (585) 259-5316.

NPI 1255645818Canandaigua, NYSpeech-Language Pathologist

Profile Overview

NPI
1255645818
Provider Type
Individual
Primary Specialty
Speech-Language Pathologist
Enumeration Date
August 05, 2010
Last Updated
August 05, 2010

Practice Location

  • 4563 Ridge RD
  • Canandaigua, NY 14424-9600

Phone: (585) 259-5316

Specialties

  • Speech-Language Pathologist (235Z00000X)
Full Record
NPI
1255645818
Entity Type
Individual
Last Name
Johnson
First Name
Lisa
Middle Name
R.
Credential
CCC-SLP
Mailing Street Address
4563 Ridge RD
Mailing City
Canandaigua
Mailing State
NY
Mailing ZIP Code
14424-9600
Mailing Country
US
Mailing Phone
(585) 259-5316
Mailing Fax
(585) 394-7547
Practice Street Address
4563 Ridge RD
Practice City
Canandaigua
Practice State
NY
Practice ZIP Code
14424-9600
Practice Country
US
Practice Phone
(585) 259-5316
Practice Fax
(585) 394-7547
Enumeration Date
August 05, 2010
Last Updated
August 05, 2010
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Speech-Language Pathologist (235Z00000X)