Provider Demographics
NPI:1619283272
Name:VILA, CARMEN JOSEFINA (MSW)
Entity Type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:JOSEFINA
Last Name:VILA
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 309
Mailing Address - Street 2:SAINT JUST STATION
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00977-0309
Mailing Address - Country:US
Mailing Address - Phone:939-244-1293
Mailing Address - Fax:
Practice Address - Street 1:CALLE 3 E1-20
Practice Address - Street 2:URBANIZACION METROPOLI
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987
Practice Address - Country:US
Practice Address - Phone:939-244-1293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical