Individual
MS. LISA M DEWEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA,CCC-SLP
Contact information
Practice address
10 PARKER LN, SUITE 1, PINEHURST, NC 28374-7903
(910) 295-3133
(910) 295-2723
Mailing address
11 RED CEDAR LN, PINEHURST, NC 28374-6918
(910) 235-3699
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3122
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28436
BCBS
NC
05
—
3403400
—
NC
01
—
562033116
TRICARE- TAX ID
NC
Enumeration date
03/16/2007
Last updated
10/27/2009
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