Provider Demographics
NPI:1265562870
Name:LOLAS, JUDITH G (LMSW ACSW)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:G
Last Name:LOLAS
Suffix:
Gender:F
Credentials:LMSW ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39169 KENNEDY DRIVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331
Mailing Address - Country:US
Mailing Address - Phone:248-553-4767
Mailing Address - Fax:
Practice Address - Street 1:8623 N WAYNE ROAD
Practice Address - Street 2:SUITE 123
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185
Practice Address - Country:US
Practice Address - Phone:734-367-0469
Practice Address - Fax:734-367-0791
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker