Provider Demographics
NPI:1780849513
Name:MEIKLE TRAYLOR, VANESSA PIERRE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:PIERRE
Last Name:MEIKLE TRAYLOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 185
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77522-0185
Mailing Address - Country:US
Mailing Address - Phone:281-703-5266
Mailing Address - Fax:
Practice Address - Street 1:4818 SHALE DR
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-2584
Practice Address - Country:US
Practice Address - Phone:281-703-5266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX340551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical