Provider Demographics
NPI:1134601479
Name:WHEELER, LORI J (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:J
Last Name:WHEELER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:J
Other - Last Name:COLLIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:2203 BRITTWAY LN
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-6029
Mailing Address - Country:US
Mailing Address - Phone:512-496-2532
Mailing Address - Fax:
Practice Address - Street 1:2203 BRITTWAY LN
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-6029
Practice Address - Country:US
Practice Address - Phone:512-496-2532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104611235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist