Provider Demographics
NPI:1841055282
Name:SANCHEZ, AIXA VIVIANA (MSW)
Entity type:Individual
Prefix:MRS
First Name:AIXA
Middle Name:VIVIANA
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MRS
Other - First Name:AIXA
Other - Middle Name:VIVIANA
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:F3 CALLE 6
Mailing Address - Street 2:
Mailing Address - City:CIDRA
Mailing Address - State:PR
Mailing Address - Zip Code:00739-3703
Mailing Address - Country:US
Mailing Address - Phone:787-981-3847
Mailing Address - Fax:
Practice Address - Street 1:F3 CALLE 6
Practice Address - Street 2:
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739-3703
Practice Address - Country:US
Practice Address - Phone:787-981-3847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR143641041C0700X
PR05208618101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty