Provider Demographics
NPI:1336262047
Name:WHITBRED, LORI E
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:E
Last Name:WHITBRED
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 1:1112 E LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-2866
Mailing Address - Country:US
Mailing Address - Phone:970-946-7606
Mailing Address - Fax:
Practice Address - Street 1:1212 W SHARP AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2600
Practice Address - Country:US
Practice Address - Phone:509-242-2308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00057017101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health