Provider Demographics
NPI:1720388085
Name:GONZALEZ CORREA, IVETTE J (MSW)
Entity Type:Individual
Prefix:MRS
First Name:IVETTE
Middle Name:J
Last Name:GONZALEZ CORREA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MRS
Other - First Name:IVETTE
Other - Middle Name:J
Other - Last Name:GONZALEZ CORREA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:PO BOX 560636
Mailing Address - Street 2:
Mailing Address - City:GUAYANILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00656-3636
Mailing Address - Country:US
Mailing Address - Phone:787-405-3043
Mailing Address - Fax:
Practice Address - Street 1:CENTRO COMERCIAL PLAZA MONSERRATE II
Practice Address - Street 2:CARR 345 KM 2.1 LOCAL 7 Y 8 OFIC 1
Practice Address - City:HORMIGUEROS
Practice Address - State:PR
Practice Address - Zip Code:00660-9998
Practice Address - Country:US
Practice Address - Phone:787-806-1835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-02
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR76821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical