Provider Demographics
NPI:1124255500
Name:MASZKA, LOREY A
Entity type:Individual
Prefix:MRS
First Name:LOREY
Middle Name:A
Last Name:MASZKA
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 1:1657 IMPERIAL CIR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-0132
Mailing Address - Country:US
Mailing Address - Phone:630-357-3005
Mailing Address - Fax:
Practice Address - Street 1:1657 IMPERIAL CIR
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-0132
Practice Address - Country:US
Practice Address - Phone:630-357-3005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-12
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor