Provider Demographics
NPI:1982877791
Name:BASSINI, JACQUELINE ZELDA (LBSW)
Entity Type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:ZELDA
Last Name:BASSINI
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 WEATHERWOOD RD
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-2361
Mailing Address - Country:US
Mailing Address - Phone:956-722-0121
Mailing Address - Fax:956-722-1916
Practice Address - Street 1:2801 FREMONT ST
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78043-2723
Practice Address - Country:US
Practice Address - Phone:956-722-0121
Practice Address - Fax:956-722-1916
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-12
Last Update Date:2008-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26070171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator