Provider Demographics
NPI:1376882803
Name:BERSHENYI, LORIANN M (RCMT,RCST,CMLDT)
Entity Type:Individual
Prefix:
First Name:LORIANN
Middle Name:M
Last Name:BERSHENYI
Suffix:
Gender:F
Credentials:RCMT,RCST,CMLDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1132 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601-3802
Mailing Address - Country:US
Mailing Address - Phone:970-618-3008
Mailing Address - Fax:
Practice Address - Street 1:1132 GRAND AVE
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-3802
Practice Address - Country:US
Practice Address - Phone:970-618-3008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-04
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6425225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist