Provider Demographics
NPI:1295190148
Name:GUZMAN, ANDRES SR
Entity Type:Individual
Prefix:MR
First Name:ANDRES
Middle Name:
Last Name:GUZMAN
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 OREGON AVE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01841-4918
Mailing Address - Country:US
Mailing Address - Phone:978-885-9590
Mailing Address - Fax:
Practice Address - Street 1:29 OREGON AVE
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-4918
Practice Address - Country:US
Practice Address - Phone:978-885-9590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-19
Last Update Date:2015-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health