Most Relevant Information
Provider Data
| NPI Number: | 1003578469 |
| Provider Name: | LYDIA DEANNE VELASQUEZ RADT |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | R1415640121 |
Most Important Dates
| Enumeration Date: | 10/12/2021 |
| Last Updated: | 02/05/2024 |
Provider Practice Location
13333 PALMDALE RD
VICTORVILLE
CA
923929364
Practice Location Phone/Fax
| Phone: | 7602414917 |
| Fax: | 7609517967 |
Provider Mailing Location
13333 PALMDALE RD
VICTORVILLE
CA
923929364
Provider Mailing Phone/Fax
| Phone: | 7604873600 |
| Fax: |