Provider Demographics
NPI:1740621234
Name:BISCONTINI, LORI (MS CCC/SLP)
Entity type:Individual
Prefix:MS
First Name:LORI
Middle Name:
Last Name:BISCONTINI
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:889 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:DURYEA
Mailing Address - State:PA
Mailing Address - Zip Code:18642-2004
Mailing Address - Country:US
Mailing Address - Phone:570-457-9381
Mailing Address - Fax:
Practice Address - Street 1:889 CENTER ST
Practice Address - Street 2:
Practice Address - City:DURYEA
Practice Address - State:PA
Practice Address - Zip Code:18642-2004
Practice Address - Country:US
Practice Address - Phone:570-457-9381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL005512L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist