Provider Demographics
NPI:1972699940
Name:PAPA, LISA A (MS, CCCA)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:A
Last Name:PAPA
Suffix:
Gender:F
Credentials:MS, CCCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3855 TEAYS VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-9622
Mailing Address - Country:US
Mailing Address - Phone:304-760-8804
Mailing Address - Fax:307-760-8815
Practice Address - Street 1:3855 TEAYS VALLEY RD
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-9622
Practice Address - Country:US
Practice Address - Phone:304-760-8804
Practice Address - Fax:307-760-8815
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVA0099231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVA0099OtherSTATE LICENSE