Healthcare Provider Details

I. General information

NPI: 1104800580
Provider Name (Legal Business Name): LORI A LYTH-FRANTZ PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 03/20/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3296 CHENEY DR
BEMUS POINT NY
14712-9765
US

IV. Provider business mailing address

3296 CHENEY DR
BEMUS POINT NY
14712-9765
US

V. Phone/Fax

Practice location:
  • Phone: 716-801-5944
  • Fax:
Mailing address:
  • Phone: 716-801-5944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number013911
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: