Provider Demographics
NPI:1528819794
Name:YEAGER, LORI (LISW)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:YEAGER
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3494 S STATE ROUTE 53
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-8837
Mailing Address - Country:US
Mailing Address - Phone:419-202-5622
Mailing Address - Fax:
Practice Address - Street 1:3494 S STATE ROUTE 53
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-8837
Practice Address - Country:US
Practice Address - Phone:419-202-5622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.2304216104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker