Provider Demographics
NPI:1851301667
Name:ALBERTS, LORI ANN (DT)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANN
Last Name:ALBERTS
Suffix:
Gender:M
Credentials:DT
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:MAIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4409 MAINE ST
Mailing Address - Street 2:PO BOX 62305
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62305
Mailing Address - Country:US
Mailing Address - Phone:217-223-0423
Mailing Address - Fax:217-223-0461
Practice Address - Street 1:4409 MAINE ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62305
Practice Address - Country:US
Practice Address - Phone:217-223-0423
Practice Address - Fax:217-223-0461
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor