Provider Information for 1144855925
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VICTORIA LUJAN BACA VILLAGOMEZ LMHC
Sex: Female
NPI: 1144855925
Last Updated: 2021-10-12
Certification Date: 2021-10-12
Certification Date: 2021-10-12
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1144855925 | ||||||||
| Enumeration Date | 2020-03-11 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 501 NE 5TH TER APT 618 FORT LAUDERDALE, FL 33301-2504 United States Phone: 480-760-1431 | Fax: | ||||||||
| Primary Practice Address | 501 NE 5TH TER APT 618 FORT LAUDERDALE, FL 33301-2504 United States Phone: 480-760-1431 | Fax: | ||||||||
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