Provider Demographics
NPI:1972765949
Name:ELOSEGUI, MARYLEN (MSW)
Entity Type:Individual
Prefix:MRS
First Name:MARYLEN
Middle Name:
Last Name:ELOSEGUI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:MARYLEN
Other - Middle Name:
Other - Last Name:ELOSEGUI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:ALTURAS DE BUCARABONES
Mailing Address - Street 2:CALLE 49 3J1
Mailing Address - City:TOA ALTA
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00953
Mailing Address - Country:UM
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ALTURAS DE BUCARABONES
Practice Address - Street 2:CALLE 49 3J1
Practice Address - City:TOA ALTA
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00953
Practice Address - Country:UM
Practice Address - Phone:787-632-1051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical