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Individual

LORETTA L. LAUDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AUD

Contact information

Practice address
100 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5401
(740) 446-5408
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5401
(740) 446-5408

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
A.01057
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000204545
OH MEDICAID UNISON
OH
05
0098575
OH
05
9460011000
WV
01
P00640947
RAILROAD MEDICARE
OH
Enumeration date
07/15/2006
Last updated
01/21/2021
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