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General NPI Number Information
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NPI Number | 1215719646
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Entity Type | Individual
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Provider Name | AIXA ESCOBAR ALEJANDRO
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Gender | Female
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Dates
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Enumeration Date | 10/19/2023
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Last Update Date | 10/27/2023
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Provider Practice Location Address
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Address Line | BO. MAMBICHE BLANCO CARR. 924 KM5.2
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City | HUMACAO
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State | PR
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Zip | 00792
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Country | US
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Telephone | 787-624-3175
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8825
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City | HUMACAO
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State | PR
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Zip | 00792-8825
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Country | US
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Telephone | 787-624-3175
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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 | 9574
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License Number State | PR
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