Provider Demographics
NPI:1316328743
Name:MARRERO, MARIANGELIE (MSW)
Entity type:Individual
Prefix:
First Name:MARIANGELIE
Middle Name:
Last Name:MARRERO
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:HC6 BOX 13648
Mailing Address - Street 2:
Mailing Address - City:COROZAL
Mailing Address - State:PR
Mailing Address - Zip Code:00783-9806
Mailing Address - Country:US
Mailing Address - Phone:787-219-1488
Mailing Address - Fax:
Practice Address - Street 1:CARR 981 KM 15.1 INT BO PUEBLO
Practice Address - Street 2:CENTRO DE SALUD INTEGRAL EN COROZAL
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783-9806
Practice Address - Country:US
Practice Address - Phone:787-859-2560
Practice Address - Fax:787-859-5390
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-11
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR133031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical