Individual
MS. LORI DIANE BRASEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
1202 E JACKSON AVE, RIVERTON, WY 82501-3866
(307) 856-4337
Mailing address
117 SMITH ST, LANDER, WY 82520-2643
(918) 237-6067
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2668
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09135452
AMERICAN SPEECH-LANGUAGE AND HEARING ASSOCIATION
—
01
—
2668
STATE OF OKLAHOMA BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY
OK
01
—
SP-891
STATE LICENSE
WY
Enumeration date
09/01/2009
Last updated
07/21/2022
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