Provider Demographics
NPI:1891970125
Name:CHRISTISON, LORI R
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:R
Last Name:CHRISTISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 COOL WATER CT
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29715-7082
Mailing Address - Country:US
Mailing Address - Phone:803-547-0444
Mailing Address - Fax:
Practice Address - Street 1:802 COOL WATER CT
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29715-7082
Practice Address - Country:US
Practice Address - Phone:803-547-0444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-05
Last Update Date:2008-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3513235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist