Provider Demographics
NPI:1538361480
Name:RICHMOND, LISA A (MA, CCC-A)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:A
Last Name:RICHMOND
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:A
Other - Last Name:PIEPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-A
Mailing Address - Street 1:510 E. NORTH BROADWAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214
Mailing Address - Country:US
Mailing Address - Phone:614-261-5451
Mailing Address - Fax:614-261-5440
Practice Address - Street 1:510 E. NORTH BROADWAY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214
Practice Address - Country:US
Practice Address - Phone:614-261-5451
Practice Address - Fax:614-261-5440
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002314A231H00000X
OHA.01874231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist