Individual
VIVIAN RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, DCSW, CAC III,
Contact information
Practice address
518 CALLE DRESDE, PUERTO NUEVO, SAN JUAN, PR 00920-3731
(787) 792-0278
(787) 792-0278
Mailing address
469 CALLE DRESDE, VILLA BORINQUEN, SAN JUAN, PR 00920-3708
(787) 792-0278
(787) 792-0278
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2740
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
660535585
TAX ID #
PR
Enumeration date
12/01/2006
Last updated
11/11/2010
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