Provider Demographics
NPI:1386946358
Name:TIMER, LORETTA A (MA,EDS,CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LORETTA
Middle Name:A
Last Name:TIMER
Suffix:
Gender:F
Credentials:MA,EDS,CCC-SLP
Other - Prefix:MRS
Other - First Name:LEE
Other - Middle Name:
Other - Last Name:TIMER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA,EDS,CCC-SLP
Mailing Address - Street 1:8917 FLEMING RD
Mailing Address - Street 2:
Mailing Address - City:FOWLERVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48836-8524
Mailing Address - Country:US
Mailing Address - Phone:517-881-7822
Mailing Address - Fax:517-223-8064
Practice Address - Street 1:8917 FLEMING RD
Practice Address - Street 2:
Practice Address - City:FOWLERVILLE
Practice Address - State:MI
Practice Address - Zip Code:48836-8524
Practice Address - Country:US
Practice Address - Phone:517-881-7822
Practice Address - Fax:517-223-8064
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-24
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist