Provider Demographics
NPI:1467462275
Name:PYTER, LORI L (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:L
Last Name:PYTER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 814
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53022-0814
Mailing Address - Country:US
Mailing Address - Phone:414-297-9232
Mailing Address - Fax:262-695-8879
Practice Address - Street 1:161 W WISCONSIN AVE
Practice Address - Street 2:2C
Practice Address - City:PEWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53072-3467
Practice Address - Country:US
Practice Address - Phone:414-297-9232
Practice Address - Fax:262-695-8879
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2486-057103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical