Provider Demographics
NPI:1225134042
Name:STIRITZ, LORI LYNN (MA CCCA)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:LYNN
Last Name:STIRITZ
Suffix:
Gender:F
Credentials:MA CCCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 UNIVERSITY DR TEXAS STATE UNIVERSITY SAN MARCOS
Mailing Address - Street 2:SPEECH LANGUAGE HEARING CLINIC
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666
Mailing Address - Country:US
Mailing Address - Phone:512-245-8241
Mailing Address - Fax:512-245-9640
Practice Address - Street 1:601 UNIVERSITY DR TEXAS STATE UNIVERSITY SAN MARCOS
Practice Address - Street 2:SPEECH LANGUAGE HEARING CLINIC
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666
Practice Address - Country:US
Practice Address - Phone:512-245-8241
Practice Address - Fax:512-245-9640
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50677231H00000X, 237600000X, 231HA2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110020803Medicaid
TX517700OtherBCBS
TX110020801Medicaid
TX517700OtherBCBS