Individual
EUGENY P TILVALDIEV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
204 WALTER ST, YOAKUM, TX 77995-1720
(718) 506-1115
Mailing address
3912 GERVASI, SAN ANTONIO, TX 78261-1725
(210) 204-3803
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
64268
TX
Other
Enumeration date
10/24/2022
Last updated
10/24/2022
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