Individual
LISA BUONORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC/SLP
Contact information
Practice address
74 SAVAGE DR, UPPER HOLLAND, PA 19053-1552
(215) 582-9831
Mailing address
74 SAVAGE DR, UPPER HOLLAND, PA 19053-1552
(215) 582-9831
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
004594-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001119496
AMERICAN SPEECH/LANGUAGE ASSOCIATION
PA
01
—
004594-L
PA STATE LICENSE
PA
Enumeration date
02/04/2017
Last updated
02/04/2017
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