Provider Demographics
NPI:1518127661
Name:SWANSON, LORI A (PHD CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:A
Last Name:SWANSON
Suffix:
Gender:F
Credentials:PHD CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 S THIRD ST
Mailing Address - Street 2:WEB B31 SPEECH & HEARING CLINIC UW RIVER FALLS
Mailing Address - City:RIVER FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54022
Mailing Address - Country:US
Mailing Address - Phone:715-425-3801
Mailing Address - Fax:715-425-3800
Practice Address - Street 1:410 S THIRD ST
Practice Address - Street 2:WEB B31 SPEECH & HEARING CLINIC UW RIVER FALLS
Practice Address - City:RIVER FALLS
Practice Address - State:WI
Practice Address - Zip Code:54022
Practice Address - Country:US
Practice Address - Phone:715-425-3801
Practice Address - Fax:715-425-3800
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3059154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist