MEDICARE: MRS. LORI A BUTLER CCC-SLP/A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	009678	NY

General Provider Information

NPI Number	:	1699910554
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LORI A BUTLER CCC-SLP/A

Provider Business Mailing Address
First Line	:	2120 COUNTY ROUTE 35
Second Line	:
City	:	NORWOOD
State	:	NY
Zip	:	13668-3149
Country	:	US
Telephone Number	:	315-265-7742
Fax Number	:

Provider Business Practice Location Address
First Line	:	2120 COUNTY ROUTE 35
Second Line	:
City	:	NORWOOD
State	:	NY
Zip	:	13668-3149
Country	:	US
Telephone Number	:	315-265-7742
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2008
Last Update Date	:	12/07/2008

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Directions to “ MRS. LORI A BUTLER CCC-SLP/A” Practice Location

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