Provider Demographics
NPI:1740401306
Name:ROSS, LORI LOUISE (MA, CCC)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:LOUISE
Last Name:ROSS
Suffix:
Gender:F
Credentials:MA, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13844 JACKSON STREET
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602
Mailing Address - Country:US
Mailing Address - Phone:303-280-6706
Mailing Address - Fax:303-280-6706
Practice Address - Street 1:13844 JACKSON STREET
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80602
Practice Address - Country:US
Practice Address - Phone:303-280-6706
Practice Address - Fax:303-280-6706
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0359045235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist