Provider Demographics
NPI:1679307755
Name:LOZANO DIAZ, LINDA GEORGINA (RBT)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:GEORGINA
Last Name:LOZANO DIAZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 NW 16TH AVE APT 12
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-5565
Mailing Address - Country:US
Mailing Address - Phone:954-625-9927
Mailing Address - Fax:
Practice Address - Street 1:119 NW 16TH AVE APT 12
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-5565
Practice Address - Country:US
Practice Address - Phone:954-625-9927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty