Provider Demographics
NPI:1134600661
Name:GALARZA, ALEXIS (MSW)
Entity type:Individual
Prefix:MR
First Name:ALEXIS
Middle Name:
Last Name:GALARZA
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:MR
Other - First Name:ALEXIS
Other - Middle Name:
Other - Last Name:GALARZA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:CALLE PALMER ESQ VICENTE PALES 1 SUR
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00784
Mailing Address - Country:US
Mailing Address - Phone:787-866-1449
Mailing Address - Fax:
Practice Address - Street 1:CALLE PALMER ESQ VICENTE PALES 1 SUR
Practice Address - Street 2:
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-866-1449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-23
Last Update Date:2021-01-25
Deactivation Date:2020-05-06
Deactivation Code:
Reactivation Date:2020-08-12
Provider Licenses
StateLicense IDTaxonomies
PR14515104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty