Provider Demographics
NPI:1518697754
Name:SERRANO, NERITZA MARIE (CSW)
Entity Type:Individual
Prefix:
First Name:NERITZA
Middle Name:MARIE
Last Name:SERRANO
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:V4 CALLE 19
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-3200
Mailing Address - Country:US
Mailing Address - Phone:939-280-8676
Mailing Address - Fax:
Practice Address - Street 1:V4 CALLE 19
Practice Address - Street 2:
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-3200
Practice Address - Country:US
Practice Address - Phone:939-280-8676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-11
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR146591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty