Healthcare Provider Details

I. General information

NPI: 1215855713
Provider Name (Legal Business Name): LORIEN E LATTIG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 AUGUSTA DR
WESTAMPTON NJ
08060-4718
US

IV. Provider business mailing address

17 BRAINERD ST
MOUNT HOLLY NJ
08060-1944
US

V. Phone/Fax

Practice location:
  • Phone: 609-686-4640
  • Fax:
Mailing address:
  • Phone: 973-896-9801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: