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NPI Code Detail

MEDICARE: JUANITA MILDRED RUBIO LCSW

MEDICARE:   JUANITA MILDRED RUBIO  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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1831800960
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUANITA MILDRED RUBIO LCSW
Provider Business Mailing Address
First Line : 1912 TIM FOSTER ST
Second Line :
City : EL PASO
State : TX
Zip : 79938-3215
Country : US
Telephone Number : 915-781-9702
Fax Number :
Provider Business Practice Location Address
First Line : 1475 RAYNOLDS ST
Second Line :
City : EL PASO
State : TX
Zip : 79903-3251
Country : US
Telephone Number : 718-298-3822
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2022
Last Update Date : 12/09/2022

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Directions to “ JUANITA MILDRED RUBIO LCSW” Practice Location

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