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Individual
LORA PERREAULT
Active
Individual
LORA PERREAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSWR
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
0000043939
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00030241501
UNIVERA
NY
01
—
160743251-32
PRISM
NY
Enumeration date
02/05/2007
Last updated
07/08/2007
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