Provider Demographics
NPI:1699538967
Name:JIRAU, MARIA LUISA (MA)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:LUISA
Last Name:JIRAU
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:MARIA
Other - Middle Name:LUISA
Other - Last Name:TORRES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:123 GRASSHOPPER LN
Mailing Address - Street 2:
Mailing Address - City:GREENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18426-7446
Mailing Address - Country:US
Mailing Address - Phone:570-390-0550
Mailing Address - Fax:
Practice Address - Street 1:116 LARCH ST FL 3
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18509-2802
Practice Address - Country:US
Practice Address - Phone:570-489-5561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health