Provider Demographics
NPI:1720187107
Name:BEHRINGER, LISA RENEE (AUD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:RENEE
Last Name:BEHRINGER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MRS
Other - First Name:LISA
Other - Middle Name:RENEE
Other - Last Name:BEHRINGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:135 W. DARES BEACH RD FREEDOM HEARING CENTER
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678
Mailing Address - Country:US
Mailing Address - Phone:443-295-7100
Mailing Address - Fax:
Practice Address - Street 1:7247 HANOVER PARKWAY SUITE A
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770
Practice Address - Country:US
Practice Address - Phone:443-295-7100
Practice Address - Fax:443-295-7555
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00721237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD407PMedicare PIN
MD807GMedicare PIN