Provider Demographics
NPI:1518047687
Name:CAROZZA, LORI (MA,CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:
Last Name:CAROZZA
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1123 BLUE STEM DR UNIT 30C
Mailing Address - Street 2:
Mailing Address - City:PAWLEYS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29585-8234
Mailing Address - Country:US
Mailing Address - Phone:843-979-4119
Mailing Address - Fax:
Practice Address - Street 1:38 LAKES AT LITCHFIELD DR
Practice Address - Street 2:
Practice Address - City:PAWLEYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29585-5768
Practice Address - Country:US
Practice Address - Phone:843-237-0343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011662-1235Z00000X
SC3960235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist