Provider Demographics
NPI:1811292311
Name:DOSS, LORI MARTIN (CCC-SLP)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:MARTIN
Last Name:DOSS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 GORDON RD
Mailing Address - Street 2:
Mailing Address - City:CALLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:24530-4001
Mailing Address - Country:US
Mailing Address - Phone:434-724-9013
Mailing Address - Fax:
Practice Address - Street 1:502 GORDON RD
Practice Address - Street 2:
Practice Address - City:CALLANDS
Practice Address - State:VA
Practice Address - Zip Code:24530-4001
Practice Address - Country:US
Practice Address - Phone:434-724-9013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-14
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202003798235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist