Lavina Terese Leon Guerrero Camacho, M.S., MFT-136

Individual provider Active NPI Marriage & Family Therapist · Hagatna, GU

NPI 1871908202 · NPPES record last updated Jun 24, 2014

Key facts

NPI
1871908202
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
MFT-136 (GU)
Practice address
194 Hernan Cortez Avenue
Dphss Project Karinu Suite 208
Hagatna, GU 96910
Phone
(671) 478-5418
NPI assigned
Jun 24, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
MFT-136GUMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT-136 GU Yes

Addresses

Primary practice location

194 Hernan Cortez Avenue
Dphss Project Karinu Suite 208
Hagatna, GU 96910

Mailing address

185 Nalao Place
Barrigada, GU 96913

Other providers in Hagatna, GU

All providers in Hagatna, GU · Marriage & Family Therapist in Guam

Sources for this page

Verify at the official NPI Registry.