Provider Demographics
NPI:1841609674
Name:PATINO, LILIANA
Entity Type:Individual
Prefix:MRS
First Name:LILIANA
Middle Name:
Last Name:PATINO
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 1:200 MOUNTAIN AVE APT 63
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-2748
Mailing Address - Country:US
Mailing Address - Phone:781-338-7544
Mailing Address - Fax:
Practice Address - Street 1:200 MOUNTAIN AVE APT 63
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-2748
Practice Address - Country:US
Practice Address - Phone:781-424-6325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor