Individual
MS. LISA MIDWINTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.,CCC-SLP
Contact information
Practice address
53 GRAVEL ST, WILKES BARRE, PA 18705-3738
(570) 371-5600
Mailing address
86 N ATHERTON AVE, KINGSTON, PA 18704-5108
(860) 806-1665
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL011207
PA
Other
Enumeration date
01/27/2015
Last updated
01/27/2015
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