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Individual

LISA FLEMING BANNISTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA CCC-SLP

Contact information

Practice address
107 CONTEMPO AVE STE 1, WEST MONROE, LA 71291-5382
(318) 381-8520
(888) 616-5693
Mailing address
204 CHANTILLY DR, WEST MONROE, LA 71291-4704

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4577
LA

Other

Enumeration date
01/31/2018
Last updated
01/31/2018
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