Provider Demographics
NPI:1376532069
Name:DRIVER BAMBERGER, LORA JEAN (BA)
Entity Type:Individual
Prefix:MRS
First Name:LORA
Middle Name:JEAN
Last Name:DRIVER BAMBERGER
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:LORA
Other - Middle Name:JEAN
Other - Last Name:O'CONNOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:7 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060
Mailing Address - Country:US
Mailing Address - Phone:603-889-6147
Mailing Address - Fax:603-883-1568
Practice Address - Street 1:15 PROSPECT ST.
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060
Practice Address - Country:US
Practice Address - Phone:603-889-6147
Practice Address - Fax:603-594-9649
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor