Provider Demographics
NPI:1881833002
Name:RUTH, LORI ANN (MED LSLS CERT AVED)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ANN
Last Name:RUTH
Suffix:
Gender:F
Credentials:MED LSLS CERT AVED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 SOUTH 1680 EAST
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062
Mailing Address - Country:US
Mailing Address - Phone:801-796-8327
Mailing Address - Fax:
Practice Address - Street 1:890 SOUTH 1680 EAST
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:UT
Practice Address - Zip Code:84062
Practice Address - Country:US
Practice Address - Phone:801-796-8327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC10806060235500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist