Provider Demographics
NPI:1447491550
Name:MONSISVAIS, LISA D (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:D
Last Name:MONSISVAIS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 W STATE HIGHWAY 6
Mailing Address - Street 2:SUITE 115
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-7544
Mailing Address - Country:US
Mailing Address - Phone:254-399-8255
Mailing Address - Fax:254-235-3408
Practice Address - Street 1:611 W STATE HIGHWAY 6
Practice Address - Street 2:SUITE 115
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-7544
Practice Address - Country:US
Practice Address - Phone:254-399-8255
Practice Address - Fax:254-235-3408
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-19
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24892235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist