Provider Demographics
NPI:1629526181
Name:MOJICA, CHERLY (MSW)
Entity Type:Individual
Prefix:
First Name:CHERLY
Middle Name:
Last Name:MOJICA
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:HC 70 BOX 30585
Mailing Address - Street 2:
Mailing Address - City:SAN LORENZO
Mailing Address - State:PR
Mailing Address - Zip Code:00754-9706
Mailing Address - Country:US
Mailing Address - Phone:787-372-0282
Mailing Address - Fax:
Practice Address - Street 1:COND MAGA
Practice Address - Street 2:BARRIO MONACILLOS CENTRO MEDICO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-1966
Practice Address - Country:US
Practice Address - Phone:787-766-4646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR135441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical