Provider Demographics
NPI:1982921243
Name:LORIE DALTON
Entity Type:Organization
Organization Name:LORIE DALTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEVELOPMENTAL INTERVENTIONIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LORIE
Authorized Official - Middle Name:BROWN
Authorized Official - Last Name:DALTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-387-4348
Mailing Address - Street 1:PO BOX 212
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:KY
Mailing Address - Zip Code:42602-0212
Mailing Address - Country:US
Mailing Address - Phone:606-387-4348
Mailing Address - Fax:606-387-3185
Practice Address - Street 1:1539 WOLF RIVER DOCK ROAD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:KY
Practice Address - Zip Code:42602-0212
Practice Address - Country:US
Practice Address - Phone:606-387-4348
Practice Address - Fax:606-387-3185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-27
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY222Q00000X252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency