Individual
LORI J STANDISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., MFT
Contact information
Practice address
190 BROAD ST, NEW LONDON, CT 06320-5367
(860) 501-4048
Mailing address
95 WEST RD, COLCHESTER, CT 06415-1838
(860) 917-0118
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008049393
—
CT
Enumeration date
01/05/2015
Last updated
04/20/2018
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