Individual
LORELEI BENHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
4151 GUNNIN RD, PEACHTREE CORNERS, GA 30092-1951
(678) 687-0119
Mailing address
4151 GUNNIN RD, PEACHTREE CORNERS, GA 30092-1951
(678) 687-0119
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP009088
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14086292
ASHA
—
01
—
SLP009088
GEORGIA LICENSE
GA
Enumeration date
08/15/2022
Last updated
08/15/2022
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