Provider Demographics
NPI:1023385606
Name:AU, LORI P (MS,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:P
Last Name:AU
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:P
Other - Last Name:HO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:67-1011 N ALULIKE RD
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-5602
Mailing Address - Country:US
Mailing Address - Phone:808-521-3885
Mailing Address - Fax:
Practice Address - Street 1:65-1235A OPELO RD
Practice Address - Street 2:
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-8401
Practice Address - Country:US
Practice Address - Phone:808-521-3885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-25
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI387235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist