Provider Demographics
NPI:1255616793
Name:THRALL, LORI L
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:L
Last Name:THRALL
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 1:13418 CHRISFIELD LN
Mailing Address - Street 2:
Mailing Address - City:MC CORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46055-9646
Mailing Address - Country:US
Mailing Address - Phone:317-432-7337
Mailing Address - Fax:
Practice Address - Street 1:8809 LINDSEY CT
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-5104
Practice Address - Country:US
Practice Address - Phone:317-770-1073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-16
Last Update Date:2011-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst