Provider Demographics
NPI:1912352840
Name:CAMP, LORI CANADY (LMBT)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:CANADY
Last Name:CAMP
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 LITTLE FOREST DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-9407
Mailing Address - Country:US
Mailing Address - Phone:828-552-9032
Mailing Address - Fax:
Practice Address - Street 1:42 LITTLE FOREST DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-9407
Practice Address - Country:US
Practice Address - Phone:828-552-9032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-28
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15226225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist