Provider Demographics
NPI:1326473315
Name:CARTAGENA, MIRIAM (MSW)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:
Last Name:CARTAGENA
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:SIRIO
Mailing Address - Street 2:FM17 URBANIZACION IRLANDA HEIGHTS
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956
Mailing Address - Country:US
Mailing Address - Phone:939-717-3236
Mailing Address - Fax:
Practice Address - Street 1:AVE IRLANDA HTS # 17
Practice Address - Street 2:SIRIO FM 17
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-5359
Practice Address - Country:US
Practice Address - Phone:939-717-3236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-09
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR48041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical