Provider Demographics
NPI:1710645338
Name:GREO, GRISEL (MSW)
Entity Type:Individual
Prefix:
First Name:GRISEL
Middle Name:
Last Name:GREO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:GRISEL
Other - Middle Name:
Other - Last Name:GREO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:5 CALLE CIELO
Mailing Address - Street 2:
Mailing Address - City:PATILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00723-9347
Mailing Address - Country:US
Mailing Address - Phone:787-486-9223
Mailing Address - Fax:
Practice Address - Street 1:URB. VALLES DE LA PROVIDENCIA J5 CALLE CIELO
Practice Address - Street 2:
Practice Address - City:PATILLAS
Practice Address - State:PR
Practice Address - Zip Code:00723
Practice Address - Country:US
Practice Address - Phone:787-486-9223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR158151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR15815Other15815