Provider Demographics
NPI:1568299204
Name:LAHOZ, DARITZA SOCORRO (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:DARITZA
Middle Name:SOCORRO
Last Name:LAHOZ
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10750 COLUMBIA PIKE STE 101
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-4402
Mailing Address - Country:US
Mailing Address - Phone:301-859-4142
Mailing Address - Fax:
Practice Address - Street 1:10750 COLUMBIA PIKE SUITE 101
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901
Practice Address - Country:US
Practice Address - Phone:301-859-4142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-17
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
MDLBA2023103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst