Individual
LILLIAM I GUADALUPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
69 ORQUIDEA STREET, ESTANCIAS DE LA FUENTE, TOA ALTA, PR 00953
(787) 565-6746
Mailing address
69 ORQUIDEA ESTANCIAS DE LA FUENTE, TOA ALTA, PR 00953
(787) 565-6746
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13824
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13824
PROFESSIONAL LICENSE
PR
01
—
4158051
LICENSE
PR
Enumeration date
02/20/2019
Last updated
02/20/2019
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