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NPI 1487181327

NPI 1487181327 : VANESSA HERNANDEZ AYALA : TRUJILLO ALTO, PR

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General NPI Number Information
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    NPI Number           |    1487181327
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    Entity Type          |    Individual 
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    Provider Name        |    VANESSA HERNANDEZ AYALA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/22/2017
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    Last Update Date     |    05/22/2017
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Provider Practice Location Address
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    Address Line         |    U4 CALLE 22 URB SUNVILLE
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    City                 |    TRUJILLO ALTO
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    State                |    PR
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    Zip                  |    00776
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    Country              |    US
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    Telephone            |    787-546-5309
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    U4 CALLE 22 URB SUNVILLE
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    City                 |    TRUJILLO ALTO
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    State                |    PR
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    Zip                  |    00976
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    Country              |    US
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    Telephone            |    
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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       |    13123
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    License Number State |    PR
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