Provider Demographics
NPI:1235344672
Name:RODRIGUEZ, NIEVES M (MSW)
Entity Type:Individual
Prefix:MRS
First Name:NIEVES
Middle Name:M
Last Name:RODRIGUEZ
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 1:1689 CALLE CUERNAVACA
Mailing Address - Street 2:URB VENUS GARDENS
Mailing Address - City:RIO PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4649
Mailing Address - Country:US
Mailing Address - Phone:787-755-0417
Mailing Address - Fax:
Practice Address - Street 1:ASSMCA
Practice Address - Street 2:CENTRO SALUD MENTAL SAN PATRICIO PUERTO NUEVO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-783-0750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR20781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical