Provider Demographics
NPI:1093106577
Name:SALABARRIA, JOSE MANUEL (MSW)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:MANUEL
Last Name:SALABARRIA
Suffix:
Gender:M
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 1188
Mailing Address - Street 2:
Mailing Address - City:SAINT JUST
Mailing Address - State:PR
Mailing Address - Zip Code:00978-1188
Mailing Address - Country:US
Mailing Address - Phone:787-233-7084
Mailing Address - Fax:
Practice Address - Street 1:CONDOMINIO FONTANA TOWER CARRETERA 190
Practice Address - Street 2:APARTAMENTO 211
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00982
Practice Address - Country:US
Practice Address - Phone:787-233-7084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12877104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker