Provider Demographics
NPI:1922873603
Name:AGUILAR, MARY L (SW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:L
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:SW
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:L
Other - Last Name:AFFEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:180 HILTON AVE APT C1
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-8104
Mailing Address - Country:US
Mailing Address - Phone:516-852-5905
Mailing Address - Fax:516-243-9091
Practice Address - Street 1:180 HILTON AVE APT C1
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-8104
Practice Address - Country:US
Practice Address - Phone:516-852-5905
Practice Address - Fax:516-243-9091
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker