Provider Demographics
NPI:1639836042
Name:GARZA-MARTINEZ, RAQUEL (LMSW)
Entity type:Individual
Prefix:
First Name:RAQUEL
Middle Name:
Last Name:GARZA-MARTINEZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:RAQUEL
Other - Middle Name:
Other - Last Name:GARZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:12435 GRAN VISTA ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78233-5930
Mailing Address - Country:US
Mailing Address - Phone:210-710-2930
Mailing Address - Fax:
Practice Address - Street 1:12435 GRAN VISTA ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78233-5930
Practice Address - Country:US
Practice Address - Phone:210-710-2930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39929104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker