Provider Demographics
NPI:1992287106
Name:LORENZO, VAL MARIE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:VAL
Middle Name:MARIE
Last Name:LORENZO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:464 LAKEDALE DR
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-4288
Mailing Address - Country:US
Mailing Address - Phone:972-754-7398
Mailing Address - Fax:
Practice Address - Street 1:1101 WINDBELL ST
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-2177
Practice Address - Country:US
Practice Address - Phone:972-754-7398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15622235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist