Provider Demographics
NPI:1962541342
Name:AMON, LORI K (MA)
Entity type:Individual
Prefix:MS
First Name:LORI
Middle Name:K
Last Name:AMON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:E
Other - Last Name:KATZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:9 MILLBROOK CT
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-7918
Mailing Address - Country:US
Mailing Address - Phone:631-499-1256
Mailing Address - Fax:631-858-0891
Practice Address - Street 1:9 MILLBROOK CT
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-7918
Practice Address - Country:US
Practice Address - Phone:631-499-1256
Practice Address - Fax:631-858-0891
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005371235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist