Individual
MRS. ALEXUS BREANNA SEPULVEDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
101 NEW YORK AVE, FORT WORTH, TX 76104-1558
(817) 821-6482
Mailing address
101 NEW YORK AVE, FORT WORTH, TX 76104-1558
(214) 418-0608
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
68670
TX
Other
Enumeration date
08/07/2024
Last updated
08/12/2024
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