Provider Demographics
NPI:1487268942
Name:ALVARADO, KEILA RAQUEL (MSW)
Entity type:Individual
Prefix:MRS
First Name:KEILA
Middle Name:RAQUEL
Last Name:ALVARADO
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 1:208 CALLE GORRION URB. HACIENDA LA MONSERRATE
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-6504
Mailing Address - Country:US
Mailing Address - Phone:787-501-2629
Mailing Address - Fax:
Practice Address - Street 1:208 CALLE GORRION URB. HACIENDA LA MONSERRATE
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-501-2629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-02
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11153104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty