Provider Demographics
NPI:1407326242
Name:STRITT, LOREN KIMBERLY
Entity type:Individual
Prefix:
First Name:LOREN
Middle Name:KIMBERLY
Last Name:STRITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LOREN
Other - Middle Name:KIMBERLY
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13019 PAULINE DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-3122
Mailing Address - Country:US
Mailing Address - Phone:586-207-9255
Mailing Address - Fax:248-403-8506
Practice Address - Street 1:13019 PAULINE DR
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48315-3122
Practice Address - Country:US
Practice Address - Phone:586-207-9255
Practice Address - Fax:248-403-8506
Is Sole Proprietor?:No
Enumeration Date:2018-12-04
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician