Provider Demographics
NPI:1750127148
Name:EULLOQUI, CLAUDETT GUADALUPE
Entity type:Individual
Prefix:
First Name:CLAUDETT
Middle Name:GUADALUPE
Last Name:EULLOQUI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16000 KENO DR
Mailing Address - Street 2:
Mailing Address - City:HORIZON CITY
Mailing Address - State:TX
Mailing Address - Zip Code:79928-6526
Mailing Address - Country:US
Mailing Address - Phone:915-867-3562
Mailing Address - Fax:
Practice Address - Street 1:16000 KENO DR
Practice Address - Street 2:
Practice Address - City:HORIZON CITY
Practice Address - State:TX
Practice Address - Zip Code:79928-6526
Practice Address - Country:US
Practice Address - Phone:915-867-3562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty