Provider Demographics
NPI:1275649626
Name:MARRA, LORI JEAN (MA)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:JEAN
Last Name:MARRA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MISS
Other - First Name:LORI
Other - Middle Name:JEAN
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:403 FISHER HALL 600 FORBES AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15282-0001
Mailing Address - Country:US
Mailing Address - Phone:412-396-4200
Mailing Address - Fax:412-396-1388
Practice Address - Street 1:406 FISHER HALL 711 FORBES AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15282-0001
Practice Address - Country:US
Practice Address - Phone:412-396-4200
Practice Address - Fax:412-396-1388
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL000149L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA698542OtherHIGHMARK
PA698540OtherHIGHMARK