Provider Demographics
NPI:1992814115
Name:THARPE, LISA BLOCK
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:BLOCK
Last Name:THARPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:JOAN
Other - Last Name:BLOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2140 FRANKLIN TPKE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-5264
Mailing Address - Country:US
Mailing Address - Phone:434-836-0239
Mailing Address - Fax:434-836-0250
Practice Address - Street 1:305 GRISTMILL DR
Practice Address - Street 2:
Practice Address - City:FOREST
Practice Address - State:VA
Practice Address - Zip Code:24551-2627
Practice Address - Country:US
Practice Address - Phone:434-385-1074
Practice Address - Fax:434-385-1342
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202001193235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist