Provider Demographics
NPI:1285315515
Name:OCORO MOSQUERA, NITZY MARGOTH
Entity type:Individual
Prefix:
First Name:NITZY
Middle Name:MARGOTH
Last Name:OCORO MOSQUERA
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 1:1200 SEABROOK DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-2826
Mailing Address - Country:US
Mailing Address - Phone:214-336-9817
Mailing Address - Fax:
Practice Address - Street 1:1200 SEABROOK DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-2826
Practice Address - Country:US
Practice Address - Phone:214-336-9817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85813101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty