Provider Demographics
NPI:1710406319
Name:RIOS VEGA, TARA (LCSW)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:RIOS VEGA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10650 CULEBRA RD UNIT 104-174
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4949
Mailing Address - Country:US
Mailing Address - Phone:210-935-5888
Mailing Address - Fax:
Practice Address - Street 1:10650 CULEBRA RD UNIT 104-174
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4949
Practice Address - Country:US
Practice Address - Phone:210-935-5888
Practice Address - Fax:210-783-8713
Is Sole Proprietor?:No
Enumeration Date:2017-09-14
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical