Provider Demographics
NPI:1689281453
Name:ESCOBAR LOZADA, BETSY
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:
Last Name:ESCOBAR LOZADA
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 1:601 LUDLAM DR APT 1
Mailing Address - Street 2:
Mailing Address - City:MIAMI SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-4971
Mailing Address - Country:US
Mailing Address - Phone:786-379-0104
Mailing Address - Fax:
Practice Address - Street 1:601 LUDLAM DR APT 1
Practice Address - Street 2:
Practice Address - City:MIAMI SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33166-4971
Practice Address - Country:US
Practice Address - Phone:786-379-0104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-25
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst