Individual
MRS. LISA MARIE FIDLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
320 NEBORLEA WAY, COLLEGEVILLE, PA 19426-2104
(610) 721-3665
Mailing address
320 NEBORLEA WAY, COLLEGEVILLE, PA 19426-2104
(610) 721-3665
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
09136536
PA
Other
Enumeration date
05/20/2007
Last updated
07/08/2007
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