Provider Demographics
NPI:1689940728
Name:VERA, AMELIA (MCSW)
Entity Type:Individual
Prefix:MRS
First Name:AMELIA
Middle Name:
Last Name:VERA
Suffix:
Gender:F
Credentials:MCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CALLE FCO DE JESUS
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-2311
Mailing Address - Country:US
Mailing Address - Phone:787-566-4422
Mailing Address - Fax:
Practice Address - Street 1:10 CALLE FCO DE JESUS
Practice Address - Street 2:
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627-2311
Practice Address - Country:US
Practice Address - Phone:787-566-4422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-22
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR102651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical