Provider Demographics
NPI:1639465834
Name:GARABEDIAN, LORI C (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:C
Last Name:GARABEDIAN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 DANNY CT
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-5804
Mailing Address - Country:US
Mailing Address - Phone:631-424-3493
Mailing Address - Fax:
Practice Address - Street 1:3 DANNY CT
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-5804
Practice Address - Country:US
Practice Address - Phone:631-424-3493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-26
Last Update Date:2011-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021075235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist