# R CORDOVA TRABAJADORES SOCIALES CSP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114049418
- **Authorized official:** MRS. RITA CORDOVA CAMPOS MSW ACSW (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (787) 593-0647

## Contact information

- **Practice address:** ROAD \#2 BAYAMON SHOPPING CENTER, SUITE \#10E MINI MALL, BAYAMON, PR 00959
- **Practice address phone:** (787) 798-9097
- **Practice address fax:** (787) 740-2559
- **Mailing address:** PMB 36 PO BOX 607071, BAYAMON, PR 00960-7071
- **Mailing address phone:** (787) 798-9097
- **Mailing address fax:** (787) 740-2559

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 04/06/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 635 | APS HEALTH CARE | PR |