Most Relevant Information
Provider Data
| NPI Number: | 1003512617 |
| Provider Name: | MAYRA AGOSTO ORTEGA LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 15001 |
Most Important Dates
| Enumeration Date: | 02/06/2023 |
| Last Updated: | 02/06/2023 |
Provider Practice Location
421 CALLE RIVADAVIA VALENCIA
SAN JUAN
PR
00923
Practice Location Phone/Fax
| Phone: | 7873406455 |
| Fax: |
Provider Mailing Location
421 CALLE RIVADAVIA VALENCIA
SAN JUAN
PR
00923
Provider Mailing Phone/Fax
| Phone: | 7873406455 |
| Fax: |