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General NPI Number Information
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NPI Number | 1053977678
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Entity Type | Individual
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Provider Name | REBECA RIOS LUGO SOCIAL WORKER
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Gender | Female
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Dates
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Enumeration Date | 05/20/2019
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Last Update Date | 05/20/2019
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Provider Practice Location Address
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Address Line | 108 CALLE LOS PINOS PARCELAS AGUAS CLARAS
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City | CEIBA
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State | PR
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Zip | 00735
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Country | US
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Telephone | 939-249-6323
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Fax |
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Provider Business Mailing Address
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Address Line | HC 55 BOX 8381
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City | CEIBA
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State | PR
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Zip | 00735-9732
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Country | US
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Telephone | 939-249-6323
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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 | 11738
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License Number State | PR
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