Provider Demographics
NPI:1003385626
Name:ROYER, LORI J (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:J
Last Name:ROYER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21629-1210
Mailing Address - Country:US
Mailing Address - Phone:410-479-1460
Mailing Address - Fax:
Practice Address - Street 1:118 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:RIDGELY
Practice Address - State:MD
Practice Address - Zip Code:21660-1345
Practice Address - Country:US
Practice Address - Phone:410-479-3243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06770235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist