Provider Demographics
NPI:1477297125
Name:GORGUEIRO, VERONICA MARIA (EDS)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:MARIA
Last Name:GORGUEIRO
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:MARIA
Other - Last Name:BELTRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3114 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:TX
Mailing Address - Zip Code:75009-1657
Mailing Address - Country:US
Mailing Address - Phone:760-889-7802
Mailing Address - Fax:
Practice Address - Street 1:3114 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:TX
Practice Address - Zip Code:75009-1657
Practice Address - Country:US
Practice Address - Phone:760-889-7802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool