Provider Demographics
NPI:1437322401
Name:VAN MEIR, LORI VASQUEZ (MA)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:VASQUEZ
Last Name:VAN MEIR
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2090 NC 111 HWY N
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-9698
Mailing Address - Country:US
Mailing Address - Phone:252-208-3876
Mailing Address - Fax:
Practice Address - Street 1:707 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-4547
Practice Address - Country:US
Practice Address - Phone:252-633-4322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1346103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical