Individual
MRS. LORI BUTALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1202 SW CENTURY AVE, PORT SAINT LUCIE, FL 34953-4274
(772) 336-3871
Mailing address
1202 SW CENTURY AVE, PORT SAINT LUCIE, FL 34953-4274
(772) 336-3871
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN1637672
FL
Other
Enumeration date
01/18/2012
Last updated
01/18/2012
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