Provider Demographics
NPI:1790537280
Name:ESPOSITO, MARI VINCENZA (MSW)
Entity Type:Individual
Prefix:MRS
First Name:MARI
Middle Name:VINCENZA
Last Name:ESPOSITO
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 1:1357 AVE ASHFORD APT 124
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-1400
Mailing Address - Country:US
Mailing Address - Phone:787-479-7879
Mailing Address - Fax:
Practice Address - Street 1:1357 AVE ASHFORD APT 124
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-1400
Practice Address - Country:US
Practice Address - Phone:787-479-7879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR68231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical