Provider Demographics
NPI:1053038083
Name:BARRETT, LORI A (RTR, CT, RDMS,LNA)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:A
Last Name:BARRETT
Suffix:
Gender:F
Credentials:RTR, CT, RDMS,LNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 VETERAN'S DRIVE
Mailing Address - Street 2:
Mailing Address - City:WRJ
Mailing Address - State:VT
Mailing Address - Zip Code:05001
Mailing Address - Country:US
Mailing Address - Phone:802-229-5963
Mailing Address - Fax:
Practice Address - Street 1:163 VETERAN'S DRIVE
Practice Address - Street 2:
Practice Address - City:WRJ
Practice Address - State:VT
Practice Address - Zip Code:05001
Practice Address - Country:US
Practice Address - Phone:802-229-5963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT051.00008612085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT051.0000861OtherSTATE OF VERMONT