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Individual

MS. LOURDES MANTILLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
BUZON 5- 186 GALATEO ALTO, ISABELA, PR 00662
(787) 518-2773
Mailing address
SECTOR GALATEO ALTO BUZON 186 RUTA 5, ISABELA, PR 00662
(787) 518-2773

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
17232
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
17232
SOCIAL WORKER LIC
PR
Enumeration date
06/22/2012
Last updated
06/22/2012
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