Provider Demographics
NPI:1689021438
Name:ISCHEN, LORI (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:
Last Name:ISCHEN
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 1:2130 8TH ST S
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57006-3507
Mailing Address - Country:US
Mailing Address - Phone:605-696-4700
Mailing Address - Fax:605-696-4704
Practice Address - Street 1:2130 8TH ST S
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-3507
Practice Address - Country:US
Practice Address - Phone:605-696-4700
Practice Address - Fax:605-696-4704
Is Sole Proprietor?:No
Enumeration Date:2016-05-23
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD219235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist