Provider Demographics
NPI:1750592135
Name:STORFER, LORI ROSE (MSCCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ROSE
Last Name:STORFER
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5163 LAKEWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33330-2633
Mailing Address - Country:US
Mailing Address - Phone:954-680-4901
Mailing Address - Fax:
Practice Address - Street 1:5163 LAKEWOOD DR
Practice Address - Street 2:
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33330-2633
Practice Address - Country:US
Practice Address - Phone:954-680-4901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 2490235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist