Provider Demographics
NPI:1124275029
Name:GEBERT, LISA ANN (AUD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:ANN
Last Name:GEBERT
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:LISA
Other - Middle Name:ANN
Other - Last Name:SARGENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:5454 WISCONSIN AVE STE 1540
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-6954
Mailing Address - Country:US
Mailing Address - Phone:301-652-8847
Mailing Address - Fax:301-652-3751
Practice Address - Street 1:5454 WISCONSIN AVE STE 1540
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-6954
Practice Address - Country:US
Practice Address - Phone:301-652-8847
Practice Address - Fax:301-652-3751
Is Sole Proprietor?:No
Enumeration Date:2008-08-21
Last Update Date:2019-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01141231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist