Individual
LISA A. BAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC SP
Contact information
Practice address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 389-3469
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5511
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
330
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42710100
—
WI
Enumeration date
08/21/2006
Last updated
05/05/2026
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