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Individual

MRS. LISA ANN IMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
18676 US HIGHWAY 17, HAMPSTEAD, NC 28443-4049
(910) 821-1700
(910) 319-9105
Mailing address
509 CLEARBROOK DR, WILMINGTON, NC 28409-5901
(757) 839-2884

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
15004
NC
235Z00000X
Speech-Language Pathologist
2202006558
VA
235Z00000X
Speech-Language Pathologist
SLP012723
GA

Other

Enumeration date
12/22/2015
Last updated
09/04/2024
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