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General NPI Number Information
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NPI Number | 1013773159
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Entity Type | Individual
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Provider Name | WANDA I IRIZARRY MS SOCIAL WORK
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Gender | Female
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Dates
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Enumeration Date | 02/26/2024
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | URBANIZACION VILLAS DE CANDELERO CALLE GAVIOTA, A-1
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City | HUMACAO
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State | PR
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Zip | 00791
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Country | US
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Telephone | 787-319-1636
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 550
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City | PUNTA SANTIAGO
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State | PR
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Zip | 00741-0550
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Country | US
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Telephone | 787-319-1636
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6539
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License Number State | PR
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