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Jennifer Loeravasquez
Professional Counselor in Fort Worth, Texas
NPI 1104254853

Jennifer Loeravasquez is a Professional Counselor based in Fort Worth, TX and is specialized in Professional. Jennifer Loeravasquez practices in Fort Worth, TX. The NPI Number for Jennifer Loeravasquez is 1104254853 and holds a License No. 67901 (Texas).

The current practice location address for Jennifer Loeravasquez is 3840 Hulen St, Fort Worth, TX and can be reached out via phone at 817-569-4300.

Location: 3840 Hulen St, Fort Worth, TX, 76113-2603
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1104254853
Provider Name
Jennifer Loeravasquez
Credential
Provider Entity Type
Individual
Gender
Female
Address
3840 Hulen St, Fort Worth, TX, 76113-2603
Phone Number
817-569-4300
Fax Number
Provider Enumeration Date
10/16/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
324246301 05 TX
833LPE 01 TX BCBS
institution
Provider Business Practice Location Address Details
Address
3840 Hulen St
City
Fort Worth
State
Texas
Zip
76107-7277
Phone Number
817-569-4300
Fax Number
person
Provider Business Mailing Address Details
Address
3840 Hulen St
City
Fort Worth
State
Texas
Zip
76107-7277
Phone Number
817-569-4300
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
67901 (Texas)
Definition
Definition to come...
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