Individual
LISA JANICKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-A
Contact information
Practice address
999 S BROADWAY, EAST PROVIDENCE, RI 02914-4701
(401) 431-5100
Mailing address
163 WATERMAN ST, PROVIDENCE, RI 02906-3109
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
000131
RI
231H00000X
Audiologist
Primary
00131
RI
Other
Enumeration date
11/10/2010
Last updated
09/13/2022
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