Individual
LISA V. BAZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
414 W SOLEDAD AVE STE 500Z, HAGATNA, GU 96910-5066
(671) 777-3764
(671) 477-1077
Mailing address
1264 N CHALAN CANTON TASI, YONA, GU 96915-4644
(671) 777-3764
(671) 477-1077
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-76
GU
Other
Enumeration date
10/16/2019
Last updated
10/16/2019
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