Healthcare Provider Details

I. General information

NPI: 1225134042
Provider Name (Legal Business Name): LORI LYNN STIRITZ MA CCCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 07/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 UNIVERSITY DR TEXAS STATE UNIVERSITY SAN MARCOS SPEECH LANGUAGE HEARING CLINIC
SAN MARCOS TX
78666
US

IV. Provider business mailing address

601 UNIVERSITY DR TEXAS STATE UNIVERSITY SAN MARCOS SPEECH LANGUAGE HEARING CLINIC
SAN MARCOS TX
78666
US

V. Phone/Fax

Practice location:
  • Phone: 512-245-8241
  • Fax: 512-245-9640
Mailing address:
  • Phone: 512-245-8241
  • Fax: 512-245-9640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number50677
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number50677
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number50677
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: