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Individual

MRS. LORA JEANETTE MANDERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LLPC, CAADC, PAC

Contact information

Practice address
1200 N MAIN ST, ADRIAN, MI 49221-1759
(517) 263-1800
Mailing address
8765 LEWIS AVE, TEMPERANCE, MI 48182-9300
(734) 847-3802
(734) 850-0520

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
C-02189
MI
101YM0800X
Mental Health Counselor
6401010851
MI
363A00000X
Physician Assistant
Primary
5601008012
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1194133082
MI
01
M35150147
MEDICARE PTAN
MI
Enumeration date
07/24/2014
Last updated
03/03/2026
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