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General NPI Number Information
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NPI Number | 1982191342
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Entity Type | Individual
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Provider Name | MS. MARINELLY RIOS GUTIERREZ
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Gender | Female
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Dates
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Enumeration Date | 04/20/2018
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Last Update Date | 09/10/2019
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Provider Practice Location Address
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Address Line | GABIOTA STREET H 7 MANSIONES DE MONTECASINO II
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City | TOA ALTA
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State | PR
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Zip | 00953
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Country | US
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Telephone | 787-428-6423
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Fax |
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Provider Business Mailing Address
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Address Line | GABIOTA STREET H 7 MANSIONES DE MONTECASINO II
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City | TOA ALTA
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State | PR
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Zip | 00953
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Country | US
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Telephone | 787-428-6423
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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 | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number | 1600
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 4427
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License Number State | PR
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