Provider Demographics
NPI:1013151992
Name:ANDERSON, LORI BETH (MS SLP)
Entity Type:Individual
Prefix:MISS
First Name:LORI
Middle Name:BETH
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 WRIGHT CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-2657
Mailing Address - Country:US
Mailing Address - Phone:434-665-3885
Mailing Address - Fax:
Practice Address - Street 1:1020 WRIGHT CT
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-2657
Practice Address - Country:US
Practice Address - Phone:434-665-3885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-23
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202005690235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist