Provider Demographics
NPI:1265258396
Name:GUZMAN, LIZBETH NA
Entity type:Individual
Prefix:
First Name:LIZBETH
Middle Name:NA
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LIZBETH
Other - Middle Name:NA
Other - Last Name:FERNANDEZ VERA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1218 SHILOH DR
Mailing Address - Street 2:SHILOH
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045
Mailing Address - Country:US
Mailing Address - Phone:956-949-6758
Mailing Address - Fax:
Practice Address - Street 1:1218 SHILOH DR
Practice Address - Street 2:SHILOH
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045
Practice Address - Country:US
Practice Address - Phone:956-949-6758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician