Individual
FABIAN CARMONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6104 AVENUE Q SOUTH DR, LUBBOCK, TX 79412-3700
(806) 472-3400
Mailing address
6104 AVENUE Q SOUTH DR, LUBBOCK, TX 79412-3700
(806) 472-3400
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW13636
FL
Other
Enumeration date
02/04/2020
Last updated
02/04/2020
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