Provider Demographics
NPI:1720249774
Name:MILBY, LORI JO (SLP)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:JO
Last Name:MILBY
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 1:193 WESTSIDE DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:KY
Mailing Address - Zip Code:40033-9401
Mailing Address - Country:US
Mailing Address - Phone:270-692-5655
Mailing Address - Fax:
Practice Address - Street 1:193 WESTSIDE DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:KY
Practice Address - Zip Code:40033-9401
Practice Address - Country:US
Practice Address - Phone:270-692-5655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-3069235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist