Provider Demographics
NPI:1033089958
Name:VALENTE, LISA ANNE (MASLP/L)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:ANNE
Last Name:VALENTE
Suffix:
Gender:F
Credentials:MASLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1960 W FRANKLIN DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-2917
Mailing Address - Country:US
Mailing Address - Phone:810-599-9886
Mailing Address - Fax:
Practice Address - Street 1:1960 W FRANKLIN DR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2917
Practice Address - Country:US
Practice Address - Phone:810-599-9886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-06
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7153000234235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty