Lisa Marie Fowler, MSP
Individual provider Active NPI Speech-Language Pathologist · Roebuck, NC
NPI 1609100338 · NPPES record last updated Sep 29, 2009
Key facts
- NPI
- 1609100338
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 2766 (SC)
- Practice address
- 441 Lancaster Farm Rd
Alphabet Soup Therapy
Roebuck, NC 29376 - Phone
- (864) 205-1410
- NPI assigned
- Sep 29, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2766 | SC | Yes |
Addresses
Primary practice location
441 Lancaster Farm Rd
Alphabet Soup Therapy
Roebuck, NC 29376
Mailing address
548 Asbury Neely Way
Roebuck, SC 29376
Phone (864) 415-3206
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.