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General NPI Number Information
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NPI Number | 1487963484
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Entity Type | Individual
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Provider Name | MARIAN DESARDEN VIALIZ MSW
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Gender | Female
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Dates
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Enumeration Date | 09/26/2010
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | BUEN SAMARITANO MEDICAL AND PROFESSIONAL PLAZA TERCER PISO SUITE #11
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City | AGUADA
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State | PR
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Zip | 00602-4007
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Country | US
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Telephone | 787-422-2595
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Fax |
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Provider Business Mailing Address
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Address Line | 219 CALLE A
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City | AGUADA
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State | PR
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Zip | 00602-4007
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Country | US
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Telephone | 787-422-2595
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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 | 10474
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License Number State | PR
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