Provider Demographics
NPI:1023324118
Name:BERRIOS, RAQUEL (MSW)
Entity type:Individual
Prefix:MRS
First Name:RAQUEL
Middle Name:
Last Name:BERRIOS
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:COND UNIVERSITARIO
Mailing Address - Street 2:862 CALLE ESTEBAN GONZALEZ APT 3C
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00925-2309
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:COND UNIVERSITARIO
Practice Address - Street 2:862 CALLE ESTEBAN GONZALEZ APT 3C
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00925-2309
Practice Address - Country:US
Practice Address - Phone:787-753-9432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1489104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker