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
Phone: (502) 655-8105
Fax:
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568668077 | NPPES |
| Kentucky | MEDICAID | 7100325870 |
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