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General NPI Number Information
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NPI Number | 1699409722
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Entity Type | Individual
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Provider Name | ANA VICTORIA RODRIGUEZ-VAZQUEZ CSW
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Gender | Female
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Dates
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Enumeration Date | 07/14/2022
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Last Update Date | 07/14/2022
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Provider Practice Location Address
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Address Line | CARRETERA 818 NORTE, KM 2 HM 7, SECTOR LA ESCUELITA
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City | COROZAL
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State | PR
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Zip | 00783-0078
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Country | US
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Telephone | 939-247-2796
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 478
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City | COROZAL
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State | PR
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Zip | 00783-0478
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Country | US
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Telephone | 939-247-2769
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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 | 250102
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License Number State | PR
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