Individual
MS. LISANNE SIMMS CRAVEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
9931 FOREST GREEN BLVD, LOUISVILLE, KY 40223-5123
(502) 588-0750
Mailing address
2028 STRATHMOOR BLVD, LOUISVILLE, KY 40205-2528
(502) 893-1285
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0405
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100321590
—
KY
Enumeration date
06/04/2009
Last updated
08/24/2020
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