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General NPI Number Information
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NPI Number | 1003900309
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Entity Type | Individual
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Provider Name | LORI ANN THOMAS B.A., LBSW
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Gender | Female
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 217 E SANILAC RD SUITE 2
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City | SANDUSKY
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State | MI
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Zip | 48471-1383
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Country | US
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Telephone | 810-583-0462
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Fax | 810-648-0315
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Provider Business Mailing Address
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Address Line | 3681 CHURCHILL RD
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City | IMLAY CITY
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State | MI
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Zip | 48444-8944
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Country | US
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Telephone | 810-346-3715
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6802077507
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License Number State | MI
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