Provider Demographics
NPI:1043437916
Name:AQUINO, LOURDES IVETTE (MSW)
Entity type:Individual
Prefix:MRS
First Name:LOURDES
Middle Name:IVETTE
Last Name:AQUINO
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 1055
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-1055
Mailing Address - Country:US
Mailing Address - Phone:787-632-9051
Mailing Address - Fax:
Practice Address - Street 1:183 AVE UNIV INTER
Practice Address - Street 2:SUITE 204
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-4455
Practice Address - Country:US
Practice Address - Phone:787-632-9051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2009-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR57671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical