Provider Demographics
NPI:1851698732
Name:TIMS, LORI ANN (SLP)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:ANN
Last Name:TIMS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 E MITCHELL ST
Mailing Address - Street 2:
Mailing Address - City:HUMBOLDT
Mailing Address - State:TN
Mailing Address - Zip Code:38343-3036
Mailing Address - Country:US
Mailing Address - Phone:731-784-5183
Mailing Address - Fax:731-784-2105
Practice Address - Street 1:2400 E MITCHELL ST
Practice Address - Street 2:
Practice Address - City:HUMBOLDT
Practice Address - State:TN
Practice Address - Zip Code:38343-3036
Practice Address - Country:US
Practice Address - Phone:731-784-5183
Practice Address - Fax:731-784-2105
Is Sole Proprietor?:No
Enumeration Date:2011-02-11
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1767235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist