Provider Demographics
NPI:1184056368
Name:SIMPSON, LORI MARIE (SLP)
Entity type:Individual
Prefix:MISS
First Name:LORI
Middle Name:MARIE
Last Name:SIMPSON
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 1:105 WESTLAND ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76901-3051
Mailing Address - Country:US
Mailing Address - Phone:325-340-4020
Mailing Address - Fax:325-617-7809
Practice Address - Street 1:133 W CONCHO AVE
Practice Address - Street 2:STE 106
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-6449
Practice Address - Country:US
Practice Address - Phone:325-340-4020
Practice Address - Fax:325-617-7809
Is Sole Proprietor?:No
Enumeration Date:2013-07-30
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109969235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist