Basic Information
| Provider Information | |||||||||
| NPI: | 1366485427 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AVILES | ||||||||
| FirstName: | NEREIDA | ||||||||
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| Credential: | MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 CALLE SANTA CRUZ | ||||||||
| Address2: | D 303 COND. RIVER PARK | ||||||||
| City: | BAYAMON | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009618500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7879952700 | ||||||||
| FaxNumber: | 7879952706 | ||||||||
| Practice Location | |||||||||
| Address1: | HOSTOS AVE. | ||||||||
| Address2: | #435 | ||||||||
| City: | HATO REY | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00918 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7879952700 | ||||||||
| FaxNumber: | 7879952706 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 3732 | PR | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.