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General NPI Number Information
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NPI Number | 1982914941
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Entity Type | Individual
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Provider Name | PAOLA MERCEDES MORENO WAZLAVEK LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/08/2010
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 4900 CATTLE LN
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City | EL PASO
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State | TX
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Zip | 79934-2835
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Country | US
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Telephone | 915-487-6828
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Fax |
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Provider Business Mailing Address
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Address Line | 4900 CATTLE LN
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City | EL PASO
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State | TX
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Zip | 79934-2835
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Country | US
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Telephone | 915-487-6828
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW9414
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 111985
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C-10576
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License Number State | NM
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