Provider Demographics
NPI:1265645857
Name:MEYERS, LORI K (MS, CCC)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:K
Last Name:MEYERS
Suffix:
Gender:F
Credentials:MS, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 S BROADWAY STE 200
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-4039
Mailing Address - Country:US
Mailing Address - Phone:405-340-7056
Mailing Address - Fax:405-330-0480
Practice Address - Street 1:2500 S BROADWAY STE 200
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-4039
Practice Address - Country:US
Practice Address - Phone:405-340-7056
Practice Address - Fax:405-330-0480
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK989235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist