Provider Demographics
NPI:1093799900
Name:LLOYD, LAURA L (MS CCC SLP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:L
Last Name:LLOYD
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:LEE
Other - Last Name:DOWLING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS CCC SLP
Mailing Address - Street 1:1605 ST RT 60
Mailing Address - Street 2:STE 3
Mailing Address - City:VERMILION
Mailing Address - State:OH
Mailing Address - Zip Code:44089
Mailing Address - Country:US
Mailing Address - Phone:440-967-2508
Mailing Address - Fax:440-967-4023
Practice Address - Street 1:1605 ST RT 60
Practice Address - Street 2:STE 3
Practice Address - City:VERMILION
Practice Address - State:OH
Practice Address - Zip Code:44089
Practice Address - Country:US
Practice Address - Phone:440-967-2508
Practice Address - Fax:440-967-4023
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP3877235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000362179OtherANTHEM BLUE CROSS