Provider Demographics
NPI:1508071556
Name:WEINER, LOIS I (PT, LMSW)
Entity Type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:I
Last Name:WEINER
Suffix:
Gender:F
Credentials:PT, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 E 130TH AVE
Mailing Address - Street 2:UNIT B
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-3933
Mailing Address - Country:US
Mailing Address - Phone:720-982-3783
Mailing Address - Fax:888-313-1418
Practice Address - Street 1:1160 E 130TH AVE
Practice Address - Street 2:UNIT B
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-3933
Practice Address - Country:US
Practice Address - Phone:720-982-3783
Practice Address - Fax:888-313-1418
Is Sole Proprietor?:No
Enumeration Date:2007-05-13
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039291104100000X
CO90852251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No104100000XBehavioral Health & Social Service ProvidersSocial Worker