Individual
MISS LORYNE D IRVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1601 E 28TH ST, TRENTON, MO 64683-1178
(660) 359-4487
(660) 359-4129
Mailing address
PO BOX 30, TRENTON, MO 64683-0030
(660) 359-4487
(660) 359-4129
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
001155
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10001133800
COMMUNITY HEALTH PLAN
—
01
—
27285011
BLUE CROSS BLUE SHIELD
—
Enumeration date
11/06/2006
Last updated
07/08/2007
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