Provider Demographics
NPI:1386428886
Name:KUZNIETSOVA, LILIIA N/A
Entity type:Individual
Prefix:
First Name:LILIIA
Middle Name:N/A
Last Name:KUZNIETSOVA
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 1:22 DANIELS RD
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-2704
Mailing Address - Country:US
Mailing Address - Phone:774-423-8180
Mailing Address - Fax:
Practice Address - Street 1:22 DANIELS RD
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-2704
Practice Address - Country:US
Practice Address - Phone:774-423-8180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health