Individual
LORI A PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,LCSW
Contact information
Practice address
415 W BASELINE SPUR RD, GLOBE, AZ 85501
(928) 402-9297
(928) 402-9414
Mailing address
415 W BASELINE SPUR RD, GLOBE, AZ 85501
(928) 402-9297
(928) 402-9414
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-12565
AZ
Other
Enumeration date
09/23/2008
Last updated
09/23/2008
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