Provider Demographics
NPI:1114398674
Name:FROMOWITZ, LORI ALLISON (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:ALLISON
Last Name:FROMOWITZ
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 WINTER ST APT 2
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2234
Mailing Address - Country:US
Mailing Address - Phone:206-383-3810
Mailing Address - Fax:
Practice Address - Street 1:27 WINTER ST APT 2
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2234
Practice Address - Country:US
Practice Address - Phone:206-383-3810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-09
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9456235Z00000X
MESP2477235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist