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General NPI Number Information
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NPI Number | 1316343072
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Entity Type | Individual
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Provider Name | LORI JEAN CHAMOT LSW
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Gender | Female
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Dates
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Enumeration Date | 11/07/2014
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Last Update Date | 11/07/2014
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Provider Practice Location Address
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Address Line | 190 BANGOR RD
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City | ELLSWORTH
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State | ME
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Zip | 04605-3258
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Country | US
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Telephone | 207-667-3239
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Fax | 207-667-0171
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Provider Business Mailing Address
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Address Line | 190 BANGOR RD
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City | ELLSWORTH
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State | ME
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Zip | 04605-3258
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Country | US
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Telephone | 207-667-3239
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Fax | 207-667-0171
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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 | LSX14465
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License Number State | ME
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