Most Relevant Information
Provider Data
| NPI Number: | 1003449919 |
| Provider Name: | LORI SLACK MSCCCSLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | SL007005 |
Most Important Dates
| Enumeration Date: | 02/19/2020 |
| Last Updated: | 02/19/2020 |
Provider Practice Location
208 PENNKNOLL RD
EVERETT
PA
155376940
Practice Location Phone/Fax
| Phone: | 8146233200 |
| Fax: |
Provider Mailing Location
208 PENNKNOLL RD
EVERETT
PA
155376940
Provider Mailing Phone/Fax
| Phone: | 8146233200 |
| Fax: |