Provider Demographics
NPI:1063001949
Name:NORGART, LORI (CCC-A/SLP)
Entity type:Individual
Prefix:MS
First Name:LORI
Middle Name:
Last Name:NORGART
Suffix:
Gender:F
Credentials:CCC-A/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3904 9TH AVE W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-1704
Mailing Address - Country:US
Mailing Address - Phone:941-747-8193
Mailing Address - Fax:941-747-3573
Practice Address - Street 1:3904 9TH AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-1704
Practice Address - Country:US
Practice Address - Phone:941-747-8193
Practice Address - Fax:941-747-3573
Is Sole Proprietor?:No
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA2294235Z00000X
FLAY549231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist