Provider Demographics
NPI:1932483799
Name:RODRIGUEZ, LEYVA (MS, SW)
Entity Type:Individual
Prefix:MRS
First Name:LEYVA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MS, SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 CALLE ALMENDRO
Mailing Address - Street 2:LOS COLOBOS PARK
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-8326
Mailing Address - Country:US
Mailing Address - Phone:787-688-1240
Mailing Address - Fax:
Practice Address - Street 1:139 CALLE ALMENDRO
Practice Address - Street 2:LOS COLOBOS PARK
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-8326
Practice Address - Country:US
Practice Address - Phone:787-688-1240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10309104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker