Provider Demographics
NPI:1750695359
Name:NAVARRO, ERNESTINA
Entity type:Individual
Prefix:
First Name:ERNESTINA
Middle Name:
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND LAUREL
Mailing Address - Street 2:VIVIANDA TRANSICIONAL BAYAMON
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956-3273
Mailing Address - Country:US
Mailing Address - Phone:787-750-1552
Mailing Address - Fax:
Practice Address - Street 1:LAUREL AVENUE
Practice Address - Street 2:VIVIENDA TRANSICIONAL BAYAMON
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-750-1552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-06
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6528104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker