Individual
GUSTAVO GARAY-VIDAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
5616 W VALLEY CIR, EL PASO, TX 79932-1900
(915) 373-1294
Mailing address
5616 W VALLEY CIR, EL PASO, TX 79932-1900
(915) 373-1294
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SWB-2022-0049
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18677037
—
NM
Enumeration date
08/12/2011
Last updated
11/22/2024
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