Provider Demographics
NPI:1265026785
Name:CINTRON GONZALEZ, WANDA I (LCSW)
Entity Type:Individual
Prefix:
First Name:WANDA
Middle Name:I
Last Name:CINTRON GONZALEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BO. PALOMAS CALLE 1 7A
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-0000
Mailing Address - Country:US
Mailing Address - Phone:787-951-1697
Mailing Address - Fax:
Practice Address - Street 1:BO. PALOMAS CALLE 1 7A
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-0000
Practice Address - Country:US
Practice Address - Phone:787-951-1697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR146011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical