Provider Demographics
NPI:1609172790
Name:CONDE, GRISEL RODRIGUEZ (MSW)
Entity Type:Individual
Prefix:MRS
First Name:GRISEL
Middle Name:RODRIGUEZ
Last Name:CONDE
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:PO BOX 3
Mailing Address - Street 2:
Mailing Address - City:BARCELONETA
Mailing Address - State:PR
Mailing Address - Zip Code:00617-0003
Mailing Address - Country:US
Mailing Address - Phone:787-614-8968
Mailing Address - Fax:787-854-0030
Practice Address - Street 1:PLAZA PUERTA DEL SOL CALLE MIGUEL OTERO
Practice Address - Street 2:202 SUITE 101
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-854-0001
Practice Address - Fax:787-854-0030
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7677101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health