Provider Demographics
NPI:1215755855
Name:RODRIGUEZ MUNIZ, NYNOSCHKA MARIE (MSW)
Entity type:Individual
Prefix:
First Name:NYNOSCHKA
Middle Name:MARIE
Last Name:RODRIGUEZ MUNIZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. HORIZONTE CALLE AURORA C7
Mailing Address - Street 2:
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-0001
Mailing Address - Country:US
Mailing Address - Phone:939-319-3924
Mailing Address - Fax:
Practice Address - Street 1:719 AVE ESCORIAL
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-4732
Practice Address - Country:US
Practice Address - Phone:939-319-3924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR166451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical