Provider Demographics
NPI:1912486218
Name:ROEMER, LANI (MS)
Entity Type:Individual
Prefix:
First Name:LANI
Middle Name:
Last Name:ROEMER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 596
Mailing Address - Street 2:
Mailing Address - City:GOODING
Mailing Address - State:ID
Mailing Address - Zip Code:83330-0596
Mailing Address - Country:US
Mailing Address - Phone:208-860-1340
Mailing Address - Fax:208-595-2276
Practice Address - Street 1:202 14TH AVE E
Practice Address - Street 2:
Practice Address - City:GOODING
Practice Address - State:ID
Practice Address - Zip Code:83330-1829
Practice Address - Country:US
Practice Address - Phone:208-860-1340
Practice Address - Fax:208-595-2276
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist