Provider Demographics
NPI:1558573840
Name:CLINE, LORI EMILY (MAED-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:EMILY
Last Name:CLINE
Suffix:
Gender:F
Credentials:MAED-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 LACY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:WEST LIBERTY
Mailing Address - State:KY
Mailing Address - Zip Code:41472-8667
Mailing Address - Country:US
Mailing Address - Phone:606-743-3909
Mailing Address - Fax:
Practice Address - Street 1:605 LACY CREEK RD
Practice Address - Street 2:
Practice Address - City:WEST LIBERTY
Practice Address - State:KY
Practice Address - Zip Code:41472-8667
Practice Address - Country:US
Practice Address - Phone:606-743-3909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2667235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1447OtherFIRST STEPS PROVIDER NUMB