Provider Demographics
NPI:1093211872
Name:WHITCOMB, LORIE
Entity Type:Individual
Prefix:
First Name:LORIE
Middle Name:
Last Name:WHITCOMB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42410 BOB HOPE DR STE 1
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-4468
Mailing Address - Country:US
Mailing Address - Phone:760-341-9619
Mailing Address - Fax:760-565-7104
Practice Address - Street 1:42410 BOB HOPE DR STE 1
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-4468
Practice Address - Country:US
Practice Address - Phone:760-341-9619
Practice Address - Fax:760-565-7104
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA8306237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist