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General NPI Number Information
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NPI Number | 1982877791
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Entity Type | Individual
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Provider Name | JACQUELINE ZELDA BASSINI LBSW
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Gender | Female
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Dates
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Enumeration Date | 04/12/2008
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Last Update Date | 04/12/2008
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Provider Practice Location Address
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Address Line | 2801 FREMONT ST
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City | LAREDO
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State | TX
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Zip | 78043-2723
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Country | US
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Telephone | 956-722-0121
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Fax | 956-722-1916
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Provider Business Mailing Address
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Address Line | 104 WEATHERWOOD RD
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City | LAREDO
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State | TX
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Zip | 78041-2361
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Country | US
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Telephone | 956-722-0121
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Fax | 956-722-1916
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 26070
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License Number State | TX
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