MEDICARE: MS. LORI JEAN MALNATI LCSW

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	1041C0700X	Clinical Social Worker	214084	MA

General Provider Information

NPI Number	:	1700057171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LORI JEAN MALNATI LCSW

Provider Business Mailing Address
First Line	:	41 LOMBARD RD
Second Line	:
City	:	HUBBARDSTON
State	:	MA
Zip	:	01452-1526
Country	:	US
Telephone Number	:	978-928-3382
Fax Number	:

Provider Business Practice Location Address
First Line	:	205 SCHOOL ST
Second Line	:	SUITE 202
City	:	GARDNER
State	:	MA
Zip	:	01440-2781
Country	:	US
Telephone Number	:	978-632-2321
Fax Number	:

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

Provider Enumeration Date	:	03/13/2008
Last Update Date	:	03/13/2008

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