Provider Demographics
NPI:1033987599
Name:JAVIER, LIZVANESSA
Entity Type:Individual
Prefix:
First Name:LIZVANESSA
Middle Name:
Last Name:JAVIER
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 1:119R FOSTER ST BLDG 13
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-5975
Mailing Address - Country:US
Mailing Address - Phone:978-531-0767
Mailing Address - Fax:978-531-1012
Practice Address - Street 1:119R FOSTER ST BLDG 13
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-5975
Practice Address - Country:US
Practice Address - Phone:978-531-0767
Practice Address - Fax:978-531-1012
Is Sole Proprietor?:No
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator