Individual
LISA KNUDSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.,SLP
Contact information
Practice address
1000 EDDY STREET, PROVIDENCE, RI 02905
(401) 533-9100
Mailing address
1000 EDDY STREET, PROVIDENCE, RI 02905
(401) 533-9100
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
53064
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4600103
MEETING STREET
RI
Enumeration date
10/08/2008
Last updated
10/08/2008
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