Provider Demographics
NPI:1730897901
Name:SUAREZ, LILIAN GEORGINA
Entity type:Individual
Prefix:MS
First Name:LILIAN
Middle Name:GEORGINA
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:LILLY
Other - Middle Name:
Other - Last Name:MORFIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11457 KAMLOOPS PL
Mailing Address - Street 2:
Mailing Address - City:LAKE VIEW TERRACE
Mailing Address - State:CA
Mailing Address - Zip Code:91342-7314
Mailing Address - Country:US
Mailing Address - Phone:661-523-9144
Mailing Address - Fax:
Practice Address - Street 1:1515 W 190TH ST STE 300
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90248-4925
Practice Address - Country:US
Practice Address - Phone:310-819-4523
Practice Address - Fax:877-394-6799
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst