Individual
LORI CLARK GENRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA-CCC-SLP
Contact information
Practice address
516 W BIJOU ST, COLORADO SPRINGS, CO 80905-1311
(719) 633-9114
(719) 329-0495
Mailing address
516 W BIJOU ST, COLORADO SPRINGS, CO 80905-1311
(719) 633-9114
(719) 329-0495
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
25654004
—
CO
Enumeration date
06/29/2012
Last updated
08/13/2015
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