Provider Demographics
NPI:1770899882
Name:MAGLINGER, LISA DAWN
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:DAWN
Last Name:MAGLINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:DAWN
Other - Last Name:PATRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3509 QUEENS WAY
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-6938
Mailing Address - Country:US
Mailing Address - Phone:270-302-3154
Mailing Address - Fax:
Practice Address - Street 1:3509 QUEENS WAY
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-6938
Practice Address - Country:US
Practice Address - Phone:270-302-3154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency