Provider Demographics
NPI:1699089961
Name:LLOYD, AZIZAH TAHIRA
Entity type:Individual
Prefix:
First Name:AZIZAH
Middle Name:TAHIRA
Last Name:LLOYD
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 1:310 PARKSIDE RD
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-2846
Mailing Address - Country:US
Mailing Address - Phone:917-533-5950
Mailing Address - Fax:
Practice Address - Street 1:310 PARKSIDE RD
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-2846
Practice Address - Country:US
Practice Address - Phone:917-533-5950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-29
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005334101YM0800X
NJ37PC00791800101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health