Provider Demographics
NPI:1578158085
Name:RODRIGUEZ TORRES, ANAILI JEANNETTE (MSW)
Entity Type:Individual
Prefix:
First Name:ANAILI
Middle Name:JEANNETTE
Last Name:RODRIGUEZ TORRES
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:H6 PASEO FLAMBOYAN
Mailing Address - Street 2:URB ESTANCIAS DEL GUAYABAL
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795
Mailing Address - Country:US
Mailing Address - Phone:939-441-6619
Mailing Address - Fax:
Practice Address - Street 1:161 PASEO FLAMBOYAN
Practice Address - Street 2:
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795-9218
Practice Address - Country:US
Practice Address - Phone:939-441-6619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-05
Last Update Date:2021-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR154841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR15484OtherMSW