Provider Demographics
NPI:1912150764
Name:DANIA, JUAN (EDD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:
Last Name:DANIA
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:566 CALLE ARRIGOITIA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3727
Mailing Address - Country:US
Mailing Address - Phone:787-249-0166
Mailing Address - Fax:
Practice Address - Street 1:867 AVE MUNOZ RIVERA
Practice Address - Street 2:STE B102
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00925-2109
Practice Address - Country:US
Practice Address - Phone:787-249-0166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-24
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR250103TA0400X
PR1232103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)