Provider Demographics
NPI:1710724927
Name:SILIEZAR, LORENA (CCHT)
Entity type:Individual
Prefix:
First Name:LORENA
Middle Name:
Last Name:SILIEZAR
Suffix:
Gender:F
Credentials:CCHT
Other - Prefix:
Other - First Name:LORENA
Other - Middle Name:D
Other - Last Name:SILIEZAR CUADRA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CCHT
Mailing Address - Street 1:22943 MEADOW MIST RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-3326
Mailing Address - Country:US
Mailing Address - Phone:301-919-3136
Mailing Address - Fax:
Practice Address - Street 1:20111 CENTURY BLVD STE B
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-9164
Practice Address - Country:US
Practice Address - Phone:301-540-4601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other