Individual
DANIEL MIRANDA FONSECA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
COND MAGNOLIA GDNS, P-12, BAYAMON, PR 00956-7100
(787) 785-9282
(787) 200-0482
Mailing address
COND MAGNOLIA GDNS, P-12, BAYAMON, PR 00956-7100
(787) 785-9282
(787) 200-0482
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12842
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12842
LICENSE
PR
Enumeration date
05/01/2015
Last updated
05/01/2015
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