Doctor Name: | JACINTO ROBERT YBARRA |
NPI Number: | 1740312958 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | S24204 |
Business Practice Address: | 1005 B St Floresville, TX - 781141900 |
Business Phone Number: | 8302164326 |
Business Fax Number: | 8302164881 |
Mailing Address: | Po Box 725, 19965 Fm 3175 N. LYTLE |
State: | TX |
Postal Code: | 780520725 |
Phone Number: | 2103570369 |
Fax Number: | 2103570458 |
NPI Enumeration Date: | 03/12/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | S24204 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |