Ivy, Lisa Fratesi
Ivy, Lisa Fratesi is an sole proprietor health care provider with primary practice located at 206 George Hall, Rebel Drive , University MS 38677-8800. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Ivy, Lisa Fratesi can be contacted via phone (662) 915-5291.Contact Information
Primary practice address
206 George Hall, Rebel Drive
University MS 38677-8800
Phone: (662) 915-5291
Fax: (662) 915-7263
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | S2411 | Mississippi |
Profile Details
| NPI number | 1285827493 |
|---|---|
| LBN Legal business name | Ivy, Lisa Fratesi |
| Credentials | M.S., CCC/SLP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 21st, 2007 |
| Last updated | Oct 22nd, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285827493 | NPPES |
| Mississippi | MEDICAID | 03275793 |
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