MEDICARE: JESSICA DEL FIERRO LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	103322	TX

General Provider Information

NPI Number	:	1326820481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA DEL FIERRO LCSW

Provider Business Mailing Address
First Line	:	5522 FIREFLY AVE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77017-6404
Country	:	US
Telephone Number	:	832-629-0259
Fax Number	:

Provider Business Practice Location Address
First Line	:	5522 FIREFLY AVE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77017-6404
Country	:	US
Telephone Number	:	832-629-0259
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2023
Last Update Date	:	10/13/2023

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