Individual
MRS. LISA MARIE MACINNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
504 TRANSOM CT, TOMS RIVER, NJ 08753-4429
(732) 674-6255
Mailing address
504 TRANSOM CT, TOMS RIVER, NJ 08753-4429
(732) 674-6255
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00519300
NJ
Other
Enumeration date
02/22/2009
Last updated
09/13/2011
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