Healthcare Provider Details

I. General information

NPI: 1841055282
Provider Name (Legal Business Name): AIXA VIVIANA SANCHEZ MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AIXA VIVIANA SANCHEZ MSW

II. Dates (important events)

Enumeration Date: 02/15/2024
Last Update Date: 02/15/2024
Certification Date: 10/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

F3 CALLE 6
CIDRA PR
00739-3703
US

IV. Provider business mailing address

F3 CALLE 6
CIDRA PR
00739-3703
US

V. Phone/Fax

Practice location:
  • Phone: 787-981-3847
  • Fax:
Mailing address:
  • Phone: 787-981-3847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number05208618
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14364
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: