Provider Demographics
NPI:1851461149
Name:MINOR-HONORE, LORI A (MFTI)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:A
Last Name:MINOR-HONORE
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21016 CANYON RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92532
Mailing Address - Country:US
Mailing Address - Phone:951-471-8859
Mailing Address - Fax:951-358-4213
Practice Address - Street 1:224 W GRAHAM AVE
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530-3740
Practice Address - Country:US
Practice Address - Phone:951-318-1351
Practice Address - Fax:866-340-6736
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 63088106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist