Provider Demographics
NPI:1558083816
Name:LANTERN SPEECH AND READING INTERVENTION
Entity Type:Organization
Organization Name:LANTERN SPEECH AND READING INTERVENTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:LAURAL
Authorized Official - Middle Name:
Authorized Official - Last Name:FARRELL LALU
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:757-945-8091
Mailing Address - Street 1:296 PATRICKS XING
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-2606
Mailing Address - Country:US
Mailing Address - Phone:757-945-8091
Mailing Address - Fax:
Practice Address - Street 1:1769 JAMESTOWN RD STE 217
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-2307
Practice Address - Country:US
Practice Address - Phone:757-945-8091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty