| Doctor Name: | MRS. LORI BUTALA |
| NPI Number: | 1033480439 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | RN1637672 |
| Business Practice Address: | 1202 Sw Century Ave Port Saint Lucie, FL - 349534274 |
| Business Phone Number: | 7723363871 |
| Business Fax Number: | |
| Mailing Address: | 1202 Sw Century Ave, PORT SAINT LUCIE |
| State: | FL |
| Postal Code: | 349534274 |
| Phone Number: | 7723363871 |
| Fax Number: | |
| NPI Enumeration Date: | 01/18/2012 |
| NPI Last Update Date: | 01/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | RN1637672 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |