Provider Demographics
NPI:1508197971
Name:VELEZ, MARIANO (MSW)
Entity Type:Individual
Prefix:MR
First Name:MARIANO
Middle Name:
Last Name:VELEZ
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 BDA VARSOVIA
Mailing Address - Street 2:
Mailing Address - City:YABUCOA
Mailing Address - State:PR
Mailing Address - Zip Code:00767-3720
Mailing Address - Country:US
Mailing Address - Phone:787-224-4517
Mailing Address - Fax:
Practice Address - Street 1:8 BDA VARSOVIA
Practice Address - Street 2:
Practice Address - City:YABUCOA
Practice Address - State:PR
Practice Address - Zip Code:00767-3720
Practice Address - Country:US
Practice Address - Phone:787-224-4517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-24
Last Update Date:2010-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR96611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical