Provider Demographics
NPI:1720951932
Name:VICTORIA ESCOBAR, MELITZA ITZEL
Entity type:Individual
Prefix:
First Name:MELITZA
Middle Name:ITZEL
Last Name:VICTORIA ESCOBAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELITZA
Other - Middle Name:ITZEL
Other - Last Name:VICTORIA-ESCOBAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8558 BLACK STAR CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2649
Mailing Address - Country:US
Mailing Address - Phone:240-918-2363
Mailing Address - Fax:
Practice Address - Street 1:8558 BLACK STAR CIR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2649
Practice Address - Country:US
Practice Address - Phone:240-918-2363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician