Provider Demographics
NPI:1407602899
Name:GASCA HERNANDEZ, VERENICE
Entity type:Individual
Prefix:MRS
First Name:VERENICE
Middle Name:
Last Name:GASCA HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:VERENICE
Other - Middle Name:
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10468 TURTLE BACK DR
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-8244
Mailing Address - Country:US
Mailing Address - Phone:405-465-5152
Mailing Address - Fax:
Practice Address - Street 1:401 E MEMORIAL RD STE 700
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-2287
Practice Address - Country:US
Practice Address - Phone:855-444-5664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician