Provider Demographics
NPI:1598406415
Name:LORENZO, ILIANA SR (COUNSELOR)
Entity Type:Individual
Prefix:MRS
First Name:ILIANA
Middle Name:
Last Name:LORENZO
Suffix:SR
Gender:F
Credentials:COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 SHERWOOD LN
Mailing Address - Street 2:
Mailing Address - City:RAYNHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02767-1623
Mailing Address - Country:US
Mailing Address - Phone:617-368-0750
Mailing Address - Fax:
Practice Address - Street 1:67 SHERWOOD LN
Practice Address - Street 2:
Practice Address - City:RAYNHAM
Practice Address - State:MA
Practice Address - Zip Code:02767-1623
Practice Address - Country:US
Practice Address - Phone:781-407-0470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health