Provider Demographics
NPI:1114119716
Name:CAPUZZI, LOIS E (PHD CCCSLP)
Entity Type:Individual
Prefix:DR
First Name:LOIS
Middle Name:E
Last Name:CAPUZZI
Suffix:
Gender:F
Credentials:PHD CCCSLP
Other - Prefix:
Other - First Name:LOIS
Other - Middle Name:E
Other - Last Name:DEMOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1829 SW 17TH STREET
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1829 SW 17TH ST
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-6406
Practice Address - Country:US
Practice Address - Phone:561-736-5302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA2993235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist