Provider Demographics
NPI:1457669830
Name:ASENCIO, DIANA (MSW)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:
Last Name:ASENCIO
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:HC 1 BOX 8111
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-9547
Mailing Address - Country:US
Mailing Address - Phone:787-635-9937
Mailing Address - Fax:
Practice Address - Street 1:HC 1 BOX 8111
Practice Address - Street 2:
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623-9547
Practice Address - Country:US
Practice Address - Phone:787-635-9937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-19
Last Update Date:2010-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR100681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical