NPI 1962738112 · live from the CMS NPI Registry
Lisa Renee Banuelos-Martin, MA CCC-SLP
Speech-Language Pathologist, in Livingston, MT. National Provider Identifier 1962738112, active.
NPI record
| NPI | 1962738112 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Speech-Language Pathologist, 235Z00000X |
| Practice location | 601 Robin Ln, Livingston, MT 59047 |
| Practice phone | 406-222-7231 |
| Mailing address | 504 S 13th St, Livingston, MT 59047 |
| Enumerated | October 22, 2009 |
| Last updated | March 11, 2014 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Speech-Language Pathologist, primary | 235Z00000X | 1225 (MT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.