Provider Demographics
NPI:1033661954
Name:MARIN, JANITZA (MSW)
Entity Type:Individual
Prefix:
First Name:JANITZA
Middle Name:
Last Name:MARIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6022
Mailing Address - Street 2:PMB 6
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00988
Mailing Address - Country:US
Mailing Address - Phone:787-675-0663
Mailing Address - Fax:
Practice Address - Street 1:B3 CALLE LUIS MUNOZ RIVERA
Practice Address - Street 2:URB MARTORELL
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646
Practice Address - Country:US
Practice Address - Phone:787-675-0663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR118241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical