Individual
LISA D WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
368 W PIKE ST, SUITE 204, LAWRENCEVILLE, GA 30045-3240
(770) 755-5278
(770) 755-5682
Mailing address
368 W PIKE ST, SUITE 204, LAWRENCEVILLE, GA 30045-3240
(770) 755-5278
(770) 755-5682
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP001688
GA
Other
Enumeration date
02/02/2009
Last updated
02/02/2009
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