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NPI Code Detail

MEDICARE: MIRAKEL GRACE MAYORAL-GOODWIN LMSW

MEDICARE: MIRAKEL GRACE MAYORAL-GOODWIN LMSW
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
1104100000XSocial Worker109069TX

General Provider Information

NPI Number : 1609650480
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIRAKEL GRACE MAYORAL-GOODWIN LMSW
Provider Business Mailing Address
First Line : 11110 BRAEWICK DR
Second Line :
City : HOUSTON
State : TX
Zip : 77096-5819
Country : US
Telephone Number : 978-902-6715
Fax Number :
Provider Business Practice Location Address
First Line : 5959 WEST LOOP S STE 430
Second Line :
City : BELLAIRE
State : TX
Zip : 77401-2403
Country : US
Telephone Number : 713-660-0776
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2023
Last Update Date : 08/22/2023

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Directions to “ MIRAKEL GRACE MAYORAL-GOODWIN LMSW” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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