Provider Demographics
NPI:1386838191
Name:LOPEZ, JEISHALY (TRABAJADORA SOCIAL)
Entity Type:Individual
Prefix:
First Name:JEISHALY
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:TRABAJADORA SOCIAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC -01 BOX 6656
Mailing Address - Street 2:
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771
Mailing Address - Country:US
Mailing Address - Phone:787-204-6668
Mailing Address - Fax:
Practice Address - Street 1:HC 1 BOX 6656
Practice Address - Street 2:
Practice Address - City:LAS PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00771-9752
Practice Address - Country:US
Practice Address - Phone:787-204-6668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-05
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker