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Individual

MRS. LORRAINE P SIDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA MS RN CS APRN

Contact information

Practice address
2151 DEEP CREEK RD, PERKIOMENVILLE, PA 18074
(215) 541-9089
(215) 679-3144
Mailing address
2151 DEEP CREEK RD, PERKIOMENVILLE, PA 18074
(215) 541-9089
(215) 679-3144

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
101YP2500X
Professional Counselor
364S00000X
Clinical Nurse Specialist
RN248822L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0005815320
AETNA
01
0492730000
KEYSTONE & AMERIHEALTH
Enumeration date
10/06/2006
Last updated
09/11/2025
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