Provider Demographics
NPI:1215656111
Name:LIEB, LORA NICOLE (AUD)
Entity type:Individual
Prefix:MS
First Name:LORA
Middle Name:NICOLE
Last Name:LIEB
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2321 ATHERHOLT RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-2113
Mailing Address - Country:US
Mailing Address - Phone:434-947-3993
Mailing Address - Fax:434-847-2941
Practice Address - Street 1:2321 ATHERHOLT RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-2113
Practice Address - Country:US
Practice Address - Phone:434-947-3993
Practice Address - Fax:434-847-2941
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001872237600000X
VA1215656111237600000X
VA2201001893237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter