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General NPI Number Information
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NPI Number | 1316540685
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Entity Type | Individual
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Provider Name | MARIANGELY SEGUI AVILES
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Gender | Female
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Dates
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Enumeration Date | 11/19/2020
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Last Update Date | 10/21/2022
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Provider Practice Location Address
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Address Line | CALLE COLON #4 CARR. 115 KM. 24.5 EDIF. AGUADA COMPLEX 2DO PISO SUITE 5
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City | AGUADA
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State | PR
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Zip | 00602
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Country | US
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Telephone | 787-609-6555
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Fax |
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Provider Business Mailing Address
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Address Line | HC 56 BOX 4670
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City | AGUADA
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State | PR
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Zip | 00602-8640
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Country | US
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Telephone | 787-942-8078
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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 | 14889
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License Number State | PR
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