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General NPI Number Information
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NPI Number | 1740810555
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Entity Type | Individual
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Provider Name | ELIZABETH LOZANO
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Gender | Female
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Dates
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Enumeration Date | 01/21/2020
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Last Update Date | 09/21/2021
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Provider Practice Location Address
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Address Line | 5631 S PECOS RD
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City | LAS VEGAS
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State | NV
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Zip | 89120-1961
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Country | US
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Telephone | 702-685-0877
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Fax |
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Provider Business Mailing Address
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Address Line | 2285 SPRUCE GOOSE ST APT 310
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City | LAS VEGAS
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State | NV
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Zip | 89135-2633
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Country | US
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Telephone | 424-256-5490
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 114935
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 3156
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License Number State | NV
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