Provider Demographics
NPI:1033788690
Name:PAGAN, DANIELA (LCDA)
Entity Type:Individual
Prefix:
First Name:DANIELA
Middle Name:
Last Name:PAGAN
Suffix:
Gender:F
Credentials:LCDA
Other - Prefix:
Other - First Name:DANIELA
Other - Middle Name:
Other - Last Name:PAGAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:CALLE 1 CASA 6 PARCELAS LAS PEREZ
Mailing Address - Street 2:BO. SANTANA
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612
Mailing Address - Country:US
Mailing Address - Phone:787-918-6788
Mailing Address - Fax:
Practice Address - Street 1:CALLE 1 CASA 6 PARCELAS LAS PEREZ
Practice Address - Street 2:BO. SANTANA
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-918-6788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-18
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR130881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR13088OtherSOCIAL WORKER