NPI 1144258674 · live from the CMS NPI Registry
Lisa Fazalare, M.S., CCC-A
Audiologist in Clarksburg, WV. National Provider Identifier 1144258674, active.
NPI record
| NPI | 1144258674 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Audiologist 231H00000X |
| Practice location | 1 Medical Center Drive, Clarksburg, WV 26301 |
| Practice phone | 304-623-3461 |
| Mailing address | 19 Benton Ln, Fairmont, WV 26554 |
| Enumerated | June 30, 2006 |
| Last updated | July 8, 2007 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Audiologist primary | 231H00000X | A-0111 (WV) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.