Provider Demographics
NPI:1831800960
Name:RUBIO, JUANITA MILDRED (LCSW)
Entity type:Individual
Prefix:
First Name:JUANITA
Middle Name:MILDRED
Last Name:RUBIO
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 1:1912 TIM FOSTER ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-3215
Mailing Address - Country:US
Mailing Address - Phone:915-781-9702
Mailing Address - Fax:
Practice Address - Street 1:1475 RAYNOLDS ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-3251
Practice Address - Country:US
Practice Address - Phone:718-298-3822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-09
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical