Provider Demographics
NPI:1215072590
Name:AMAN, LORI ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:ANN
Last Name:AMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 W AUGUSTA AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051-5745
Mailing Address - Country:US
Mailing Address - Phone:623-703-2027
Mailing Address - Fax:
Practice Address - Street 1:3400 N. DYSART RD.
Practice Address - Street 2:UNIT E-11, #117
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-1003
Practice Address - Country:US
Practice Address - Phone:623-536-7956
Practice Address - Fax:623-536-9806
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2014-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4538103T00000X, 103TC0700X, 103TC2200X, 103TC1900X, 103TS0200X
AZLPC 0199101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No101Y00000XBehavioral Health & Social Service ProvidersCounselor