Provider Demographics
NPI:1437999877
Name:CARRASQUILLO, LUZ MARIA
Entity type:Individual
Prefix:
First Name:LUZ
Middle Name:MARIA
Last Name:CARRASQUILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 COLE RD
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-6807
Mailing Address - Country:US
Mailing Address - Phone:919-902-1505
Mailing Address - Fax:
Practice Address - Street 1:655 COLE RD
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-6807
Practice Address - Country:US
Practice Address - Phone:919-902-1505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health