Provider Demographics
NPI:1225714827
Name:ADORNO, ANA LIZ (LCDA)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:LIZ
Last Name:ADORNO
Suffix:
Gender:F
Credentials:LCDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1247 CARR 860 APT 315
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-7239
Mailing Address - Country:US
Mailing Address - Phone:787-225-6297
Mailing Address - Fax:
Practice Address - Street 1:533 AVE ESCORIAL
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-4764
Practice Address - Country:US
Practice Address - Phone:787-225-6297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7667103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral