| Doctor Name: | IMELDA BERRIOS |
| NPI Number: | 1023256138 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 4084282 |
| Business Practice Address: | Ave. Luis Munoz Rivera 91 Santa Isabel, PR - 00757 |
| Business Phone Number: | 7878451188 |
| Business Fax Number: | 7878451188 |
| Mailing Address: | Cond. Roberto Clemente Bz 16022, CAROLINA |
| State: | PR |
| Postal Code: | 00987 |
| Phone Number: | 7872929414 |
| Fax Number: | 7878451188 |
| NPI Enumeration Date: | 01/27/2009 |
| NPI Last Update Date: | 01/27/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 4084282 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |