Provider Demographics
NPI:1922249184
Name:GOEHRIG, LORI LYNN (CCC SLP)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:LYNN
Last Name:GOEHRIG
Suffix:
Gender:F
Credentials:CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1531 NW 109TH TER
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-6431
Mailing Address - Country:US
Mailing Address - Phone:954-753-4512
Mailing Address - Fax:
Practice Address - Street 1:1531 NW 109TH TER
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-6431
Practice Address - Country:US
Practice Address - Phone:954-753-4512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist