Individual
LAURA LOUISE LILLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., SLP-CCC
Contact information
Practice address
15175 SW BRACKEN FERN CT, SHERWOOD, OR 97140-8490
(971) 330-7116
Mailing address
15175 SW BRACKEN FERN CT, SHERWOOD, OR 97140-8490
(971) 330-7116
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
15617
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500736248
—
OR
Enumeration date
11/06/2017
Last updated
10/06/2023
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