Provider Demographics
NPI:1467229062
Name:MUNIZ, KYNEISHA M (MSW)
Entity Type:Individual
Prefix:MISS
First Name:KYNEISHA
Middle Name:M
Last Name:MUNIZ
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:HC01 BOX 4693
Mailing Address - Street 2:
Mailing Address - City:RINCON
Mailing Address - State:PR
Mailing Address - Zip Code:00677
Mailing Address - Country:US
Mailing Address - Phone:787-216-0754
Mailing Address - Fax:
Practice Address - Street 1:BO PUNTAS CARR 413 KM 4 8
Practice Address - Street 2:
Practice Address - City:RINCON
Practice Address - State:SC
Practice Address - Zip Code:00677-0067
Practice Address - Country:US
Practice Address - Phone:787-216-0754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR165911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical