Provider Demographics
NPI:1639340078
Name:FURE-OLKS, LORI M (MSW)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:M
Last Name:FURE-OLKS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 CALUMET AVE
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-5425
Mailing Address - Country:US
Mailing Address - Phone:920-683-9710
Mailing Address - Fax:920-683-9755
Practice Address - Street 1:3311 CALUMET AVE
Practice Address - Street 2:
Practice Address - City:MANITOWOC
Practice Address - State:WI
Practice Address - Zip Code:54220-5425
Practice Address - Country:US
Practice Address - Phone:920-683-9710
Practice Address - Fax:920-683-9755
Is Sole Proprietor?:No
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7065-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical