Marty, Lisa Marlene

Marty, Lisa Marlene is an individual health care provider with primary practice located at 2144 County Rd 12 South , Buffalo MN 55313. 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. Marty, Lisa Marlene can be contacted via phone (763) 458-4315.

Contact Information

Primary practice address
2144 County Rd 12 South Buffalo MN 55313
Phone: (763) 458-4315
Fax: (763) 542-2280
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 6288 Minnesota

Profile Details

NPI number 1619140456
LBN Legal business name Marty, Lisa Marlene
Credentials MS CCCSLP
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 11th, 2008
Last updated Apr 11th, 2008 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619140456 NPPES
Minnesota Other 00072LI BCBS
Minnesota Other 4600226 BCBS
Minnesota Other V411933831110351 BCBS

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