National Provider Identifier

Lori Jean Southworth, MS ED

Lori Jean Southworth, MS ED is listed in the NPPES registry with a primary specialty of Specialist in West Seneca, NY and a listed phone number of (716) 297-0798.

NPI 1255693669West Seneca, NYSpecialist

Profile Overview

NPI
1255693669
Provider Type
Individual
Primary Specialty
Specialist
Enumeration Date
June 12, 2012
Last Updated
June 12, 2012

Practice Location

  • 1112 Indian Church RD
  • # 27
  • West Seneca, NY 14224-1330

Phone: (716) 297-0798

Specialties

  • Specialist (174400000X)
Full Record
NPI
1255693669
Entity Type
Individual
Last Name
Southworth
First Name
Lori
Middle Name
Jean
Credential
MS ED
Mailing Street Address
1112 Indian Church RD
Mailing Address Line 2
# 27
Mailing City
West Seneca
Mailing State
NY
Mailing ZIP Code
14224-1330
Mailing Country
US
Mailing Phone
(716) 297-0798
Mailing Fax
(716) 297-0998
Practice Street Address
1112 Indian Church RD
Practice Address Line 2
# 27
Practice City
West Seneca
Practice State
NY
Practice ZIP Code
14224-1330
Practice Country
US
Practice Phone
(716) 297-0798
Practice Fax
(716) 297-0998
Enumeration Date
June 12, 2012
Last Updated
June 12, 2012
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Specialist (174400000X)