Individual
KECIA MARIETTE VASCONEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCDC, MS MFT/C
Contact information
Practice address
4425 W AIRPORT FWY STE 430, IRVING, TX 75062-5984
(972) 607-0088
Mailing address
4425 W AIRPORT FWY STE 430, IRVING, TX 75062-5984
(972) 607-0088
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16869
TX
172V00000X
Community Health Worker
—
—
Other
Enumeration date
06/29/2019
Last updated
03/27/2024
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