Provider Demographics
NPI:1083448823
Name:LOEBSACK, TORI (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:TORI
Middle Name:
Last Name:LOEBSACK
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 RAPPS DAM RD APT 5
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-1941
Mailing Address - Country:US
Mailing Address - Phone:610-810-6067
Mailing Address - Fax:
Practice Address - Street 1:451 W RIDGE PIKE STE 479
Practice Address - Street 2:
Practice Address - City:LIMERICK
Practice Address - State:PA
Practice Address - Zip Code:19468-1415
Practice Address - Country:US
Practice Address - Phone:895-348-4369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist