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NPI Code Detail

MEDICARE: CIARA D LIZARRAGA LCMFT

MEDICARE:   CIARA D LIZARRAGA  LCMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistLCM464MD

General Provider Information

NPI Number : 1205191103
Entity Type Code : Individual
Provider Name (Legal Business Name) : CIARA D LIZARRAGA LCMFT
Provider Business Mailing Address
First Line : 3717 DECATUR AVE
Second Line : SUITE 1
City : KENSINGTON
State : MD
Zip : 20895-2148
Country : US
Telephone Number : 301-539-9159
Fax Number :
Provider Business Practice Location Address
First Line : 3717 DECATUR AVE
Second Line : SUITE 1
City : KENSINGTON
State : MD
Zip : 20895-2148
Country : US
Telephone Number : 301-539-9159
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2012
Last Update Date : 04/22/2016

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Directions to “ CIARA D LIZARRAGA LCMFT” Practice Location

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