Individual
LISA BISSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
8579 SUMMIT RD, REYNOLDSBURG, OH 43068-1411
(716) 640-6713
Mailing address
1522 MARVIN DR, REYNOLDSBURG, OH 43068-2930
(716) 640-6713
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
COND.2014164-SP
OH
235Z00000X
Speech-Language Pathologist
Primary
SP.11641
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0239789
—
OH
Enumeration date
05/27/2014
Last updated
11/07/2019
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