Individual
MS. JISELLY IRIZARRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
CALLE SOL # 120, CENTRO PONCENO DE AUTISMO, PONCE, PR 00730-4810
(787) 284-2900
Mailing address
5 CALLE 10, NUEVA VIDA, EL TUQUE, PONCE, PR 00730-3318
(787) 605-8110
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10879
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10879
MSW LICENSE
PR
Enumeration date
09/28/2011
Last updated
09/28/2011
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