Provider Demographics
NPI:1871064873
Name:LEVY, LORI (SLP)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:LEVY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7052 MECHANICSVILLE TPKE
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-3699
Mailing Address - Country:US
Mailing Address - Phone:804-723-3403
Mailing Address - Fax:
Practice Address - Street 1:8021 LEE DAVIS RD
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-3681
Practice Address - Country:US
Practice Address - Phone:804-723-2260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty