Provider Demographics
NPI:1942868948
Name:PRESTON, LORRYN ELIZABETH
Entity Type:Individual
Prefix:MS
First Name:LORRYN
Middle Name:ELIZABETH
Last Name:PRESTON
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 1:2935 BIRCH HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-2301
Mailing Address - Country:US
Mailing Address - Phone:248-837-2119
Mailing Address - Fax:
Practice Address - Street 1:2935 BIRCH HOLLOW DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-2301
Practice Address - Country:US
Practice Address - Phone:248-837-2119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician