Provider Demographics
NPI:1548639875
Name:COLBART, LORI ANN
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANN
Last Name:COLBART
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 1:3113 SW 82ND ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-4428
Mailing Address - Country:US
Mailing Address - Phone:405-818-5827
Mailing Address - Fax:
Practice Address - Street 1:3113 SW 82ND ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-4428
Practice Address - Country:US
Practice Address - Phone:405-818-5827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-16
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health