Provider Demographics
NPI:1487937397
Name:MANDEL, LORILEE (SLP)
Entity type:Individual
Prefix:MRS
First Name:LORILEE
Middle Name:
Last Name:MANDEL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6885 CAROLYN WAY
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-7470
Mailing Address - Country:US
Mailing Address - Phone:561-641-3325
Mailing Address - Fax:
Practice Address - Street 1:900 N FEDERAL HWY
Practice Address - Street 2:SUITE 220
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-2755
Practice Address - Country:US
Practice Address - Phone:561-994-6690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ5598235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist