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NPI Code Detail

MEDICARE: KATHERIN LAZO

MEDICARE:   KATHERIN  LAZO
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
1103K00000XBehavior Analyst0133003529VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982013918
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERIN LAZO
Provider Business Mailing Address
First Line : 5296 PETERS CREEK RD
Second Line :
City : ROANOKE
State : VA
Zip : 24019-3808
Country : US
Telephone Number : 540-215-0535
Fax Number :
Provider Business Practice Location Address
First Line : 5296 PETERS CREEK RD
Second Line :
City : ROANOKE
State : VA
Zip : 24019-3808
Country : US
Telephone Number : 540-215-0535
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2014
Last Update Date : 01/23/2025

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Directions to “ KATHERIN LAZO ” Practice Location

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