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General NPI Number Information
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NPI Number | 1003681099
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Entity Type | Individual
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Provider Name | SONIA MALLOL
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Gender | Female
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Dates
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Enumeration Date | 11/20/2023
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Last Update Date | 11/20/2023
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Provider Practice Location Address
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Address Line | PROFESIONAL OFFICES PARK EDIFICIO V (POP-V) PFIZER TOW SUITE 301 996 CALLE SAN ROBERTO SAN JUAN, PR
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-641-0774
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 654
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City | CATANO
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State | PR
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Zip | 00963
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Country | US
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Telephone | 787-628-3662
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 14896
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License Number State | PR
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