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Individual

MRS. MICHELE ANN LORTZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
EDM

Contact information

Practice address
4184 ROUTE 9W, WEST CAMP, NY 12490
(845) 247-0941
Mailing address
203 BAYARD ST., PO BOX 696, PORT EWEN, NY 12466
(845) 224-7519

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary

Other

Enumeration date
07/12/2017
Last updated
07/12/2017
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