Provider Demographics
NPI:1427804079
Name:PRIETO HILDALGO, LILIETY
Entity type:Individual
Prefix:
First Name:LILIETY
Middle Name:
Last Name:PRIETO HILDALGO
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 1:4135 LINDA LN
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-8527
Mailing Address - Country:US
Mailing Address - Phone:561-301-0043
Mailing Address - Fax:
Practice Address - Street 1:4135 LINDA LN
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-8527
Practice Address - Country:US
Practice Address - Phone:561-301-0043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24-325446106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician