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Individual
MRS. LISA MARLENE MARTY
Active
Individual
MRS. LISA MARLENE MARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCCSLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6288
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00072LI
BCBS
MN
01
—
4600226
MEDICA
MN
01
—
V411933831110351
HEALTH PARTNERS
MN
Enumeration date
04/11/2008
Last updated
04/11/2008
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