Provider Demographics
NPI:1548839632
Name:CALDERON, RAQUEL VILLEGAS (RBT)
Entity type:Individual
Prefix:
First Name:RAQUEL
Middle Name:VILLEGAS
Last Name:CALDERON
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1714 LAUREL PATHWAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245-4441
Mailing Address - Country:US
Mailing Address - Phone:210-577-9941
Mailing Address - Fax:
Practice Address - Street 1:1714 LAUREL PATHWAY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245-4441
Practice Address - Country:US
Practice Address - Phone:210-577-9941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician