MEDICARE: KEVILYN LORIO

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	222Q00000X	Developmental Therapist
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1972960094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVILYN LORIO

Provider Business Mailing Address
First Line	:	9403 MANSFIELD RD
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71118-3815
Country	:	US
Telephone Number	:	318-861-8938
Fax Number	:

Provider Business Practice Location Address
First Line	:	3084 WESTFORK DR STE C
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-2254
Country	:	US
Telephone Number	:	225-296-6083
Fax Number	:	225-296-6082

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

Provider Enumeration Date	:	01/20/2016
Last Update Date	:	06/13/2022

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Directions to “ KEVILYN LORIO ” Practice Location

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