Provider Demographics
NPI:1710642285
Name:BARAJAS, MIREYA (MSW)
Entity Type:Individual
Prefix:
First Name:MIREYA
Middle Name:
Last Name:BARAJAS
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 1:5232 W 25TH ST APT 3E
Mailing Address - Street 2:
Mailing Address - City:CICERO
Mailing Address - State:IL
Mailing Address - Zip Code:60804-3307
Mailing Address - Country:US
Mailing Address - Phone:708-369-5388
Mailing Address - Fax:
Practice Address - Street 1:5232 W 25TH ST APT 3E
Practice Address - Street 2:
Practice Address - City:CICERO
Practice Address - State:IL
Practice Address - Zip Code:60804-3307
Practice Address - Country:US
Practice Address - Phone:708-369-5388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker