Individual
GINA MARIE LISA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1801 E 2ND ST, SCOTCH PLAINS, NJ 07076-1749
(908) 312-9476
Mailing address
77 MCKINLEY AVE, LODI, NJ 07644-2920
(973) 868-5610
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS01224800
NJ
Other
Enumeration date
04/26/2024
Last updated
04/26/2024
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