Individual
MRS. LISA ROWE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22004121A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000353015
ANTHEM PIN #
IN
Enumeration date
11/01/2006
Last updated
07/08/2007
Update your record
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