Provider Demographics
NPI:1861939860
Name:WILLIAMMEE, LORAINE JUDITH (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LORAINE
Middle Name:JUDITH
Last Name:WILLIAMMEE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:LORAINE
Other - Middle Name:JUDITH
Other - Last Name:KOZICHOUSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1708 HOLCOMB LAKE RD
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-2092
Mailing Address - Country:US
Mailing Address - Phone:770-693-1445
Mailing Address - Fax:
Practice Address - Street 1:1708 HOLCOMB LAKE RD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-2092
Practice Address - Country:US
Practice Address - Phone:770-693-1445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-27
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006679235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist