Provider Demographics
NPI:1477277176
Name:LUCERO, JAKLIN OSMARI (SOCIAL WORKER)
Entity Type:Individual
Prefix:
First Name:JAKLIN
Middle Name:OSMARI
Last Name:LUCERO
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 INVESTOR DR APT 437
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-2934
Mailing Address - Country:US
Mailing Address - Phone:479-320-6746
Mailing Address - Fax:
Practice Address - Street 1:3900 INVESTOR DR APT 437
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-2934
Practice Address - Country:US
Practice Address - Phone:479-320-6746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker