Individual
BLESSY CHACKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
11606 ARBIRLOT DR, RICHMOND, TX 77407-2257
(973) 970-5457
Mailing address
11606 ARBIRLOT DR, RICHMOND, TX 77407-2257
(973) 970-5457
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
59317
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
394812701
—
TX
Enumeration date
01/28/2022
Last updated
06/06/2024
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