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Individual
ESDA N VELASCO
Active
Individual
ESDA N VELASCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
QMHS MA CMS MA
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251X00000X
Supports Brokerage Agency
Primary
—
—
Other
Enumeration date
06/14/2018
Last updated
06/14/2018
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