Individual
VERONCIA ROSE QUEZADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1951 ESTRELLA RD, PRESCOTT, AZ 86305-5276
(253) 905-8178
Mailing address
1951 ESTRELLA RD, PRESCOTT, AZ 86305-5276
(253) 905-8178
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LMSW-18015
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LMSW-18015
AZ BOARD OF BH
AZ
Enumeration date
10/08/2019
Last updated
10/08/2019
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