MEDICARE: LORI SUE WENIGER M.ED, NBCT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator	5947	DE

General Provider Information

NPI Number	:	1003242561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI SUE WENIGER M.ED, NBCT

Provider Business Mailing Address
First Line	:	3222 CHARLES GRIFFIN DR
Second Line	:
City	:	GARNET VALLEY
State	:	PA
Zip	:	19060-2209
Country	:	US
Telephone Number	:	302-438-4368
Fax Number	:

Provider Business Practice Location Address
First Line	:	3222 CHARLES GRIFFIN DR
Second Line	:
City	:	GARNET VALLEY
State	:	PA
Zip	:	19060-2209
Country	:	US
Telephone Number	:	302-438-4368
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2013
Last Update Date	:	09/16/2013

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