Provider Demographics
NPI:1194841908
Name:CHAMBERS, LORI DAWN (MS)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:DAWN
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 STORAGE RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-8561
Mailing Address - Country:US
Mailing Address - Phone:252-443-0318
Mailing Address - Fax:252-443-5079
Practice Address - Street 1:141 STORAGE RD
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-8561
Practice Address - Country:US
Practice Address - Phone:252-443-0318
Practice Address - Fax:252-443-5079
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2608103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist