Provider Demographics
NPI:1093234247
Name:DELLINGER, LOU J (SLP,CCC)
Entity Type:Individual
Prefix:MRS
First Name:LOU
Middle Name:J
Last Name:DELLINGER
Suffix:
Gender:F
Credentials:SLP,CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SOUTH RIVER ELEM. SCHOOL
Mailing Address - Street 2:2101 ELM AVE.
Mailing Address - City:GROTTOES
Mailing Address - State:VA
Mailing Address - Zip Code:24441
Mailing Address - Country:US
Mailing Address - Phone:540-249-4001
Mailing Address - Fax:
Practice Address - Street 1:2101 ELM AVE.
Practice Address - Street 2:SOUTH RIVER ELEM. SCHOOL
Practice Address - City:GROTTOES
Practice Address - State:VA
Practice Address - Zip Code:24441
Practice Address - Country:US
Practice Address - Phone:540-249-4001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-19
Last Update Date:2017-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202007828235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist