Individual
LISA FANNIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
325 COLONY RD, NEWPORT NEWS, VA 23602-6342
(757) 877-3132
Mailing address
325 COLONY RD, NEWPORT NEWS, VA 23602-6342
(757) 877-3132
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202003057
VA
Other
Enumeration date
01/04/2017
Last updated
01/04/2017
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