Provider Demographics
NPI:1750941019
Name:SMITH, LORRAINE J (MS: SLP)
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:J
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS: SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7980 CHAPEL HILL RD STE 115
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-4649
Mailing Address - Country:US
Mailing Address - Phone:919-535-3930
Mailing Address - Fax:
Practice Address - Street 1:7980 CHAPEL HILL RD STE 115
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-4649
Practice Address - Country:US
Practice Address - Phone:919-535-3930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2012191235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist