Individual
LORI ANN VIDRINE-HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,CCC-SLP
Contact information
Practice address
216 E 4TH ST, PORT ANGELES, WA 98362-3200
(360) 457-8575
Mailing address
216 E 4TH ST, PORT ANGELES, WA 98362-3200
(360) 457-8575
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01106649
ASHA. CERTIFICATE OF CLINICAL COMPETENCE
—
Enumeration date
12/28/2012
Last updated
12/28/2012
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