Individual
MRS. ENEDINA ELISA ENRIQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
908 E FERGUSON ST, PHARR, TX 78577-2614
(956) 342-4354
(956) 602-1271
Mailing address
908 E FERGUSON ST, PHARR, TX 78577-2614
(956) 342-4354
(956) 602-1272
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
28207
TX
1041C0700X
Clinical Social Worker
Primary
28207
TX
171W00000X
Contractor
28207
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178473807
—
TX
Enumeration date
08/05/2006
Last updated
06/10/2022
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