Conklyn, Lisa Marie

Conklyn, Lisa Marie is an individual health care provider with primary practice located at 5722 35Th Ave , Kenosha WI 53144-4124. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Conklyn, Lisa Marie can be contacted via phone (262) 652-6486.

Contact Information

Primary practice address
5722 35Th Ave Kenosha WI 53144-4124
Phone: (262) 652-6486
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 2382-154 Wisconsin

Profile Details

NPI number 1871767442
LBN Legal business name Conklyn, Lisa Marie
Credentials MS, CCC-SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 15th, 2008
Last updated Apr 15th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871767442 NPPES
Wisconsin MEDICAID 42798400

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