Provider Demographics
NPI:1982451241
Name:RIVERA CARTAGENA, SULLYNETTE (MSW)
Entity type:Individual
Prefix:
First Name:SULLYNETTE
Middle Name:
Last Name:RIVERA CARTAGENA
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:PO BOX 9655
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-9655
Mailing Address - Country:US
Mailing Address - Phone:787-326-4633
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 9655
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00726-9655
Practice Address - Country:US
Practice Address - Phone:787-326-4633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14263104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker