Provider Demographics
NPI:1124857891
Name:LOZANO, AMBER DOLORES (MS)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:DOLORES
Last Name:LOZANO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47803-1469
Mailing Address - Country:US
Mailing Address - Phone:323-709-9749
Mailing Address - Fax:
Practice Address - Street 1:1711 N 6TH 1/2 ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47804-2700
Practice Address - Country:US
Practice Address - Phone:812-238-7766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS