Organization
FUNCTIONAL LIFESTYLE SYSTEMS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI ANN PERRIN PH.D. (PSYCHOLOGIST)
(970) 690-9592
Entity
Organization
Contact information
Practice address
1303 31ST AVE, GREELEY, CO 80634-6327
(970) 690-9592
(970) 353-7888
Mailing address
1303 31ST AVE, GREELEY, CO 80634-6327
(970) 690-9592
(970) 353-7888
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60335378
—
CO
Enumeration date
01/08/2021
Last updated
12/13/2023
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