Provider Demographics
NPI:1962815175
Name:SMITH, LORINDA (SLP)
Entity Type:Individual
Prefix:
First Name:LORINDA
Middle Name:
Last Name:SMITH
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 1:723 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:PA
Mailing Address - Zip Code:16701-3242
Mailing Address - Country:US
Mailing Address - Phone:814-362-4621
Mailing Address - Fax:
Practice Address - Street 1:723 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:PA
Practice Address - Zip Code:16701-3242
Practice Address - Country:US
Practice Address - Phone:814-362-4621
Practice Address - Fax:814-362-1066
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist