Individual
MRS. LISA GAYLE BARDACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
2314 YORKSHIRE RD, SUITE 200, ANN ARBOR, MI 48104-5041
(734) 973-9670
(734) 975-6970
Mailing address
2314 YORKSHIRE RD, SUITE 200, ANN ARBOR, MI 48104-5041
(734) 973-9670
(734) 975-6970
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01080132
ASHA CERTIFICATION
—
Enumeration date
05/21/2007
Last updated
07/08/2007
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