Provider Demographics
NPI:1184843120
Name:LAWRENCE, ORPHA JILL (MS)
Entity Type:Individual
Prefix:MRS
First Name:ORPHA
Middle Name:JILL
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16300 CHASEWOOD LN
Mailing Address - Street 2:UNIT A
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99516-4827
Mailing Address - Country:US
Mailing Address - Phone:907-349-0774
Mailing Address - Fax:907-729-1260
Practice Address - Street 1:4315 DIPLOMACY DR
Practice Address - Street 2:ANC-PT
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5926
Practice Address - Country:US
Practice Address - Phone:907-729-1269
Practice Address - Fax:907-729-1260
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK27235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist