Individual
MRS. LISA KRISTINE CONNOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
500 RIVER AVE, SUITE 245, LAKEWOOD, NJ 08701-4738
(732) 367-1888
Mailing address
449 JACKSON AVE, BRICK, NJ 08723-6131
(732) 267-1631
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00455400
NJ
Other
Enumeration date
10/27/2011
Last updated
10/27/2011
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