Provider Demographics
NPI:1619678364
Name:DEL RIO LIZARDI, KAMILA
Entity Type:Individual
Prefix:
First Name:KAMILA
Middle Name:
Last Name:DEL RIO LIZARDI
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:PO BOX 3824
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00958-0824
Mailing Address - Country:US
Mailing Address - Phone:787-983-1347
Mailing Address - Fax:
Practice Address - Street 1:URBANIZACION BELMONT AT FINCA ELENA CALLE 12 #56
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-983-1347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health