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General NPI Number Information
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NPI Number | 1225863244
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Entity Type | Individual
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Provider Name | LILIANA RAQUEL MARAVILLA
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Gender | Female
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Dates
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Enumeration Date | 09/09/2024
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 1000 N GLEBE RD
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City | ARLINGTON
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State | VA
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Zip | 22201-4712
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Country | US
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Telephone | 703-908-7611
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Fax |
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Provider Business Mailing Address
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Address Line | 5809 31ST AVE
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City | HYATTSVILLE
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State | MD
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Zip | 20782-3178
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Country | US
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Telephone | 240-441-2746
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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