Provider Demographics
NPI:1609996297
Name:FOREST, LORI A (ND)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:A
Last Name:FOREST
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9 CENTRAL ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-5105
Mailing Address - Country:US
Mailing Address - Phone:207-941-0981
Mailing Address - Fax:207-941-0981
Practice Address - Street 1:9 CENTRAL ST
Practice Address - Street 2:SUITE 205
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-5105
Practice Address - Country:US
Practice Address - Phone:207-941-0981
Practice Address - Fax:207-941-0981
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MENP284175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath