Wise, Lisa Jean

Wise, Lisa Jean is an individual health care provider with primary practice located at 2200 W Highway 54 Van-Far R-1 School District, Vandalia MO 63382-1130. 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. Wise, Lisa Jean can be contacted via phone (573) 594-6111.

Contact Information

Primary practice address
2200 W Highway 54 Van-Far R-1 School District Vandalia MO 63382-1130
Phone: (573) 594-6111
Fax: (573) 594-2878
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 2002013175 Missouri

Profile Details

NPI number 1316072903
LBN Legal business name Wise, Lisa Jean
Credentials MA CCC SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 22nd, 2007
Last updated Sep 21st, 2007 - 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 1316072903 NPPES
Missouri MEDICAID 467477907

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