Provider Demographics
NPI:1639709470
Name:PITRE, LORENA
Entity Type:Individual
Prefix:
First Name:LORENA
Middle Name:
Last Name:PITRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CALLE MEDICO STE 1
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4761
Mailing Address - Country:US
Mailing Address - Phone:505-273-4668
Mailing Address - Fax:
Practice Address - Street 1:6 CALLE MEDICO STE 1
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4761
Practice Address - Country:US
Practice Address - Phone:505-273-4668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-21
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor