Provider Demographics
NPI:1245491398
Name:LORA, MARGARITA (MS, NCC)
Entity type:Individual
Prefix:MRS
First Name:MARGARITA
Middle Name:
Last Name:LORA
Suffix:
Gender:F
Credentials:MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 FARABEE DR N
Mailing Address - Street 2:SUITE C
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-5913
Mailing Address - Country:US
Mailing Address - Phone:765-586-2761
Mailing Address - Fax:765-423-5600
Practice Address - Street 1:115 FARABEE DR N
Practice Address - Street 2:SUITE C
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-5913
Practice Address - Country:US
Practice Address - Phone:765-586-2761
Practice Address - Fax:765-423-5600
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN215677101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health