Phan, Lori

Phan, Lori is an sole proprietor health care provider with primary practice located at 11110 Sewell Dr , Louisville KY 40291-4124. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as her primary health care specialty. Phan, Lori can be contacted via phone (502) 655-8105.

Contact Information

Primary practice address
11110 Sewell Dr Louisville KY 40291-4124
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 100299 Kentucky

Profile Details

NPI number 1568668077
LBN Legal business name Phan, Lori
Credentials M.A., B.C.B.A., LBA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 22nd, 2007
Last updated Aug 15th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568668077 NPPES
Kentucky MEDICAID 7100325870

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