DR. LORI LEE BOURGARD


Address: 320 Colony Point Rd S, St Petersburg, FL 33705-6227
Phone: 7277102679

DR. LORI LEE BOURGARD (NPI# 1245287655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1245287655
Entity Type Individual
Full Name DR. LORI LEE BOURGARD
Practice Address 320 Colony Point Rd S
St Petersburg
FL 33705-6227
Practice Telephone 7277102679
Enumeration Date 2006-05-30
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor X

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC1900X Psychologist
Specialization: Counseling
PY6277 FL Behavioral Health & Social Service Providers

Office Location

Street Address 320 COLONY POINT RD S
City ST PETERSBURG
State FL
Zip Code 33705-6227

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Taxonomy Information

Taxonomy Code 103TC1900X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Counseling

Taxonomy Definition

Definition to come...

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Competitor

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City ST PETERSBURG
Zip Code 33705

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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