Provider Demographics
NPI:1801064498
Name:LOZADA VELEZ, MAYTE (PHD)
Entity type:Individual
Prefix:DR
First Name:MAYTE
Middle Name:
Last Name:LOZADA VELEZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:MAYTE
Other - Middle Name:
Other - Last Name:LOZADA VELEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:HC 04 BOX 46938
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727
Mailing Address - Country:US
Mailing Address - Phone:787-961-8484
Mailing Address - Fax:787-961-8484
Practice Address - Street 1:BETANCES #23 (FIRST LEVEL)
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-961-8484
Practice Address - Fax:787-961-8484
Is Sole Proprietor?:No
Enumeration Date:2008-02-15
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2187103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling