Provider Demographics
NPI:1275744534
Name:GROSS, LORI ANNE (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:ANNE
Last Name:GROSS
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 1:4545 BISSONNET
Mailing Address - Street 2:SUITE 295
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401
Mailing Address - Country:US
Mailing Address - Phone:713-668-7655
Mailing Address - Fax:713-668-7656
Practice Address - Street 1:4545 BISSONNET
Practice Address - Street 2:SUITE 295
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3121
Practice Address - Country:US
Practice Address - Phone:713-668-7655
Practice Address - Fax:713-668-7656
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17888235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist