Provider Demographics
NPI:1427809136
Name:TAVAREZ-HERRERA, JAZMINE (MSW)
Entity type:Individual
Prefix:
First Name:JAZMINE
Middle Name:
Last Name:TAVAREZ-HERRERA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 SEVEN BRIDGE RD UNIT 114
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-7608
Mailing Address - Country:US
Mailing Address - Phone:516-515-1059
Mailing Address - Fax:
Practice Address - Street 1:529 SEVEN BRIDGE RD UNIT 114
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-7608
Practice Address - Country:US
Practice Address - Phone:516-515-1059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker