Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | 59505 | TX |
NPI | 1003223520 |
---|---|
Provider Name | Mrs. Griselda Prado Vasquez |
First Address | Laredo, TX 78043-3354 |
Second Address | Laredo, TX 78043-3354 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2014 |
Last Update Date | 29/07/2014 |