Individual
ANNALISE LIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CF-SLP
Contact information
Practice address
2505 E JEFFERSON BLVD, SOUTH BEND, IN 46615-2635
(574) 289-4831
Mailing address
217 ARCADE AVE, ELKHART, IN 46514-2466
(574) 286-5942
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
46004273A
IN
Other
Enumeration date
06/16/2023
Last updated
06/16/2023
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