Provider Demographics
NPI:1710546551
Name:MATEO, ENEIDA A (MSW)
Entity Type:Individual
Prefix:
First Name:ENEIDA
Middle Name:A
Last Name:MATEO
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:CALLE YAGRUMO # 35
Mailing Address - Street 2:ESTANCIAS DEL RIO
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729
Mailing Address - Country:US
Mailing Address - Phone:787-640-4554
Mailing Address - Fax:
Practice Address - Street 1:CALLE YAGRUMO # 35
Practice Address - Street 2:ESTANCIAS DEL RIO
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729
Practice Address - Country:US
Practice Address - Phone:787-640-4554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty