Provider Demographics
NPI:1437345501
Name:MERCATILI CIMINO, LORI ANN (MSCCC-SLP)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ANN
Last Name:MERCATILI CIMINO
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:ANN
Other - Last Name:CIMINO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSCCC-SLP
Mailing Address - Street 1:12 WHARTON CLOSE
Mailing Address - Street 2:
Mailing Address - City:MOOSIC
Mailing Address - State:PA
Mailing Address - Zip Code:18507-2121
Mailing Address - Country:US
Mailing Address - Phone:570-347-5033
Mailing Address - Fax:
Practice Address - Street 1:12 WHARTON CLOSE
Practice Address - Street 2:
Practice Address - City:MOOSIC
Practice Address - State:PA
Practice Address - Zip Code:18507-2121
Practice Address - Country:US
Practice Address - Phone:570-347-5033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL003615L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist