Provider Demographics
NPI:1336402627
Name:ZERHOUANE, LORI (SLP)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:
Last Name:ZERHOUANE
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 1:200 BON SHER DR
Mailing Address - Street 2:
Mailing Address - City:TANNERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18372-7740
Mailing Address - Country:US
Mailing Address - Phone:570-801-0516
Mailing Address - Fax:
Practice Address - Street 1:200 BON SHER DR
Practice Address - Street 2:
Practice Address - City:TANNERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18372-7740
Practice Address - Country:US
Practice Address - Phone:570-801-0516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL010866235Z00000X
NJ41YS00307700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist