Provider Demographics
NPI:1255523734
Name:LOCSIN, ANA LIZZA LACAMBRA (PT)
Entity type:Individual
Prefix:MRS
First Name:ANA LIZZA
Middle Name:LACAMBRA
Last Name:LOCSIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 DORR DR
Mailing Address - Street 2:UNIT #13
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-3853
Mailing Address - Country:US
Mailing Address - Phone:802-775-2390
Mailing Address - Fax:
Practice Address - Street 1:25 RIDGEWOOD RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VT
Practice Address - Zip Code:05156-3050
Practice Address - Country:US
Practice Address - Phone:802-885-7310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040-0003173225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist