Provider Demographics
NPI:1407896772
Name:FERNANDEZ BERRIOS, DAGMA E (MSW)
Entity Type:Individual
Prefix:MS
First Name:DAGMA
Middle Name:E
Last Name:FERNANDEZ BERRIOS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:212 CALLE SAN IGNACIO
Mailing Address - Street 2:URB. LIRIOS CALA
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-8625
Mailing Address - Country:US
Mailing Address - Phone:787-704-0705
Mailing Address - Fax:787-704-0705
Practice Address - Street 1:EDIFICIO CONSOLIDATED CALLE GAUTIER BENITEZ
Practice Address - Street 2:ANEXO B-5
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-5545
Practice Address - Country:US
Practice Address - Phone:787-704-0705
Practice Address - Fax:787-704-0705
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR65621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical