Individual
LISA ANN WILLOUGHBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,CCC/SLP
Contact information
Practice address
1064 S MAIN ST BLDG 2C, WEST CREEK, NJ 08092-2914
(609) 234-1796
Mailing address
327 N 2ND ST, SURF CITY, NJ 08008-4918
(609) 234-1796
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00335300
NJ
Other
Enumeration date
12/08/2017
Last updated
12/08/2017
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