Most Relevant Information
Provider Data
| NPI Number: | 1003479734 |
| Provider Name: | LISA MICHELLE DYMOND M.S. CCC-SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 07609 |
Most Important Dates
| Enumeration Date: | 04/18/2019 |
| Last Updated: | 04/18/2019 |
Provider Practice Location
124 GOUCHER WAY
CHURCHVILLE
MD
210281218
Practice Location Phone/Fax
| Phone: | 4109373338 |
| Fax: |
Provider Mailing Location
1000 S MARLYN AVE
BALTIMORE
MD
212215999
Provider Mailing Phone/Fax
| Phone: | 4108870112 |
| Fax: |