Provider Demographics
NPI:1730347816
Name:KLAUSMAN, LILA A (SLP)
Entity type:Individual
Prefix:
First Name:LILA
Middle Name:A
Last Name:KLAUSMAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 LAS OLAS DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32951-3469
Mailing Address - Country:US
Mailing Address - Phone:321-724-8899
Mailing Address - Fax:321-724-8899
Practice Address - Street 1:356 LAS OLAS DR
Practice Address - Street 2:
Practice Address - City:MELBOURNE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32951-3469
Practice Address - Country:US
Practice Address - Phone:321-724-8899
Practice Address - Fax:321-724-8899
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA4080235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist