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General NPI Number Information
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NPI Number | 1184066276
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Entity Type | Organization
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Legal Business Name | TRANSFORMACION FAMILIAR INC
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Dates
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Enumeration Date | 07/18/2013
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Last Update Date | 07/18/2013
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Provider Practice Location Address
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Address Line | 9 CALLE DEL CARMEN W FAJARDO PUEBLO
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City | FAJARDO
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State | PR
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Zip | 00738-4718
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Country | US
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Telephone | 787-801-0217
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Fax | 787-801-0217
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Provider Business Mailing Address
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Address Line | 9 CALLE DEL CARMEN W FAJARDO PUEBLO
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City | FAJARDO
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State | PR
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Zip | 00738-4718
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Country | US
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Telephone | 787-801-0217
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Fax | 787-801-0217
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Authorized Official
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Title or Position | PRESIDEN
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Name | MRS. VILMARIES RODRIGUEZ
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Credential |
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Telephone | 787-801-0217
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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 | 14477
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 8699
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 764
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License Number State | PR
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