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Individual
VANESSA FRAGA DEGOLLADO
Active
Individual
VANESSA FRAGA DEGOLLADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
84723
TX
101YP2500X
Professional Counselor
Primary
84723
TX
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
373188702
—
TX
Enumeration date
04/23/2019
Last updated
10/16/2023
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