Provider Demographics
NPI:1669596334
Name:LISH, HOLLI ANN (MA CCC-A)
Entity type:Individual
Prefix:
First Name:HOLLI
Middle Name:ANN
Last Name:LISH
Suffix:
Gender:F
Credentials:MA CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 W STREET RD
Mailing Address - Street 2:SUITE B104
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-3226
Mailing Address - Country:US
Mailing Address - Phone:215-672-4327
Mailing Address - Fax:215-646-0565
Practice Address - Street 1:65 W STREET RD
Practice Address - Street 2:SUITE B104
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-3226
Practice Address - Country:US
Practice Address - Phone:215-499-4528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000862-L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist