Basic Information
Provider Information
NPI: 1366883142
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KUHN
FirstName: LISA
MiddleName: ANN
NamePrefix: MRS.
NameSuffix:  
Credential: MS CCC-SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1882 WINTON ROAD SOUTH
Address2: SUITE 8
City: ROCHESTER
State: NY
PostalCode: 146183960
CountryCode: US
TelephoneNumber: 5856971557
FaxNumber: 5856975692
Practice Location
Address1: 1882 WINTON ROAD SOUTH
Address2: SUITE 8
City: ROCHESTER
State: NY
PostalCode: 146183960
CountryCode: US
TelephoneNumber: 5856971557
FaxNumber: 5856975692
Other Information
ProviderEnumerationDate: 07/09/2013
LastUpdateDate: 03/25/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/25/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X023829NYY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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