Provider Demographics
NPI:1659663318
Name:SIZEMORE, LORI B (BS, TLSW)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:B
Last Name:SIZEMORE
Suffix:
Gender:F
Credentials:BS, TLSW
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 274 RURAL RT. 10 438 RIVER ROAD
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:24874-0274
Mailing Address - Country:US
Mailing Address - Phone:304-732-0071
Mailing Address - Fax:304-732-0070
Practice Address - Street 1:438 RIVER RD
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:WV
Practice Address - Zip Code:24874-0274
Practice Address - Country:US
Practice Address - Phone:304-732-0071
Practice Address - Fax:304-732-0070
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-12
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVTL1199834R104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker