Individual
MRS. LORI A MCEVILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ITDS, MS, BS
Contact information
Practice address
19109 BECKETT DR, ODESSA, FL 33556-2266
(317) 285-9291
Mailing address
19109 BECKETT DR, ODESSA, FL 33556-2266
(317) 285-9291
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
1035337
IN
Other
Enumeration date
09/17/2010
Last updated
09/17/2010
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