Provider Demographics
NPI:1306231857
Name:LOSADA SCHOR, LIZA
Entity Type:Individual
Prefix:MRS
First Name:LIZA
Middle Name:
Last Name:LOSADA SCHOR
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 1:5004 CONTINENTAL DR
Mailing Address - Street 2:5004 CONTINENTAL DRIVE
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-2973
Mailing Address - Country:US
Mailing Address - Phone:240-688-8695
Mailing Address - Fax:
Practice Address - Street 1:5004 CONTINENTAL DR
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-2973
Practice Address - Country:US
Practice Address - Phone:240-688-8695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-01
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRN155629101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health